Check your meds: do they affect your voice?

Note: Updated in Spring 2020 include newer medications, including biologics.

The most frequently prescribed medications in the U.S.* are listed alphabetically (Column 1). Columns 2 and 3 provide additional information, and column 4 describes any known effect on voice or speech. Specific references of the effects of medications on voice or speech are limited. Thus, the following includes adverse events that involve structures required for voice or mechanisms of speech. Keep in mind that a medication’s effect on voice and speech may vary greatly from person to person due to dissimilar dosages, duration of use, and individual differences (age, overall health, other medications taken, etc.). Confused? Ask your physician or pharmacist.

Brand Name Generic Name Drug Class Effects on Voice or Speech
Abilify aripiprazole atypical antipsychotic No effects on voice or speech mechanisms have been reported.
Accolate zafirlukast antihistamine-leukotriene receptor antagonist No effects on voice or speech mechanisms have been reported.
Accupril quinapril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Accutane isotretinoin antiacne-oral retinoid Adverse mucocutaneous effects are frequently reported with isotretinoin. Cheilitis (inflammation of the lips) occurs in more than 90% of patients and appears to be dose-related. Other mucocutaneous effects frequently encountered include xerosis, xerostomia , epistaxis, peeling, and pruritus. The mucocutaneous drying effects of isotretinoin are dose-related and are usually reversible following discontinuation.
Aciphex rabeprazole proton pump inhibitor These agents have a favorable effect on the voice in that they reduce damage of gastrointestinal reflux (GERD). Uncontrolled acidic spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Actonel risedronate osteoporosis-bisphosphonate Adverse effects with oral risedronate during the clinical trials were reported as generally mild and primarily affected the gastrointestinal system. The specific events reported are acid regurgitation (4.1%) including pyrosis (heartburn), flatulence (4.1%), gastroesophageal reflux disease (GERD) (0.7%), dyspepsia (3.4%), diarrhea (1.4%), abdominal pain (2.1%), and nausea (2.1% ).
Actos pioglitazone antidiabetic-insulin sensitizer No effects on voice or speech mechanisms have been reported.
Adalat CC nifedipine cardiovascular- CCB No effects on voice or speech mechanisms have been reported.
Adderall amphetamine and dextroamphetamine stimulant Adderall may have a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes and laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Adlyxin Lixisenatide Glucagon-like peptide-1 for diabetes mellitus 2 Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether this is true for humans. However, exenatide extended-release is contraindicated in patients with a personal or family history of medullary thyroid cancer and in patients with Multiple Endocrine Neoplasia syndrome. The earlier medullary thyroid cancer is found, the more likely it can be stopped and treated. Unfortunately, there may be no early warning signs; noticeable signs and symptoms like hoarseness, difficulty swallowing, or throat lumps often don’t appear until the tumor has advanced.
Advair-diskus fluticasone and salmeterol antiasthmatic-steroid/bronchodilation Patients using inhaled steroids sometimes experience voice changes (including complete loss of voice). The onset of symptoms and severity of symptoms is highly variable among patients. Studies show that discontinuation of inhaled steroids restores the voice in dysphonic patients, but symptoms may not resolve immediately.
Aldactone spironolactone cardiovascular-diuretic Diuretics have a drying effect on mucous membranes, including those used to speaking and singing. Hoarseness, sore throat, voice changes or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Allegra fexophenadine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Altace ramipril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Amaryl glimepiride antidiabetic-sulfonylurea No effects on voice or speech mechanisms have been reported.
Ambien zolpidem sedative/hypnotic The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Amoxil amoxicillin antibiotic-penicillin In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Androderm  testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
AndroGel testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Antivert meclizine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Aranesp darbepoetin alfa recombinant human erythropoietins Transient ischemic attack-like symptoms including slurred speech, slow speech, inability to speak, and loss of voice have been reported.
Aricept donepezil cholinergic function enhancer for Alzheimer’s patients Infrequent voice and speech effects may include tongue edema, (swelling), pharyngitis (sore throat) and bronchitis.
Arixtra  fondaparinux factor Xa inhibitors: blood thinning Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Astelin azelastine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Ativan lorazepam antianxiety-benzodiazepine Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Atrovent ipratropium antiasthmatic-bronchodilation Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat man may lead to hoarseness, soreness, voice changes or laryngitis. Dry vocal tissues may be more prove to injuries, such as nodules.
Augmentin amoxicillin clavulenate antibiotic-penicillin In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Avapro irbesartan cardiovascular-AGII antagonist Although excessive coughing has been associated with the use of ACE inhibitors, and to a lesser extent AGII inhibitors, which may lead to hoarseness and possible vocal tissue damage, this effect has NOT been reported with the use of Avapro.
Aveed testosterone undecanoate hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Avelox moxifloxacin antibiotic-fluoroquinolone In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Avodart dutasteride BPH-5 alpha reductase inhibitor No effects on voice or speech mechanisms have been reported.
Axid Nizatidine gastrointestinal-H2 blocker Two effects exist: 1) the antihistamine component has a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more prone to injuries, such as nodules. 2) However, this medication may benefit the voice if it is taken to reduce acidity of gastroesophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Azmacort triamcinolone antiasthmatic-steroid inhaled Patients using inhaled steroids sometimes experience voice changes (including complete loss of voice). The onset of symptoms and severity of symptoms is highly variable among patients. Studies show that discontinuation of inhaled steroids restores the voice in dysphonic patients, but symptoms may not resolve immediately.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Bactrim sulfamethox/trimethoprin antibiotic-sulfa In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Bactroban mupirocin antibiotic No effects on voice or speech mechanisms have been reported.
Benadryl diphenhydramine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Benicar olmesartan cardiovascular-AGII antagonist An infrequently reported adverse reaction is coughing, which in turn, may cause hoarseness and possible vocal tissue damage.
Bentyl dicyclomine antispasmotic The following adverse effects are frequently associated with the use of anticholinergic agents, such as dicyclomine, at both therapeutic and subtherapeutic levels: blurred vision, cycloplegia, mydriasis, photophobia, anhidrosis, xerostomia (dry mouth), urinary retention, sinus tachycardia, palpitations, and constipation. Saliva substitutes may be administered to relieve dry mouth.
Bevyxxa betrixaban factor Xa inhibitors: oral anticoagulant Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased. 
Biaxin clarithromycin antibiotic-macrolide In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Boniva ibandronate osteoporosis-bisphosphonate Adverse events of the digestive system were reportedly the most common reason for withdrawal from clinical trials of orally administered ibandronate. In addition to dyspepsia, other reported adverse events included: constipation (2.5—4%), diarrhea (6.8% ibandronate vs. 5% placebo), esophagitis , gastritis (2.2% vs. 1.9%), pharyngitis (2.5% vs. 1.5%), and nausea/vomiting (2.7% vs. 2.1%).
Botox botulinum toxin type A onabotulinumtoxinA Indicated for treatment of blepharospasms. Side effects can include increased incidence of upper respiratory tract infections, cough, bronchitis, and possible dry mouth.
Buspar buspirone antianxiety No effects on voice or speech mechanisms have been reported.
Bydureon exenatide extended release  glucagon-like peptide-1 for diabetes mellitus 2 Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether this is true for humans. However, exenatide extended-release is contraindicated in patients with a personal or family history of medullary thyroid cancer and in patients with Multiple Endocrine Neoplasia syndrome. The earlier medullary thyroid cancer is found, the more likely it can be stopped and treated. Unfortunately, there may be no early warning signs; noticeable signs and symptoms like hoarseness, difficulty swallowing, or throat lumps often don’t appear until the tumor has advanced.
Byetta exenatide antidiabetic-incretin mimetics Other notable GI events included diarrhea (13% vs. 6% placebo) and dyspepsia (6% vs. 3% placebo). Anorexia (reported as decreased appetite) and gastroesophageal reflux were also reported in 1—5% of patients and at a higher rate than placebo.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Caduet amlodipine/ atorvastatin cardiovascular-CCB/statin Calcium channel blockers such as amlodipine should be used cautiously in patients with gastroesophageal reflux disease (GERD) or hiatal hernia associated with reflux esophagitis. The drugs relax the lower esophageal sphincter. Note that voice production can be adversely affected by GERD.
Calan verapamil cardiovascular-CCB Calcium channel blockers such as verapamil should be used cautiously in patients with gastroesophageal reflux disease (GERD) or hiatal hernia associated with reflux esophagitis. The drugs relax the lower esophageal sphincter. Note that voice production can be adversely affected by GERD.
Cardizem CD diltiazem cardiovascular- CCB Calcium channel blockers such as diltiazem should be used cautiously in patients with gastroesophageal reflux disease (GERD) or hiatal hernia associated with reflux esophagitis. The drugs relax the lower esophageal sphincter. Note that voice production can be adversely affected by GERD.
Cardura doxazosin cardiovascular-alpha blocker No effects on voice or speech mechanisms have been reported.
Catapres clonidine cardiovascular-alpha agonist No effects on voice or speech mechanisms have been reported.
Ceftin cefuroxine antibiotic-cephalosporin In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Cefzil cefprozil antibiotic-cephalosporin In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Celebrex celecoxib analgesic-NSAID- COX 2 inhibitor Less common GI effects (0.1—1.9% incidence) that occurred with celecoxib regardless of causality included anorexia, constipation, diverticulitis, gastritis, gastroenteritis, gastroesophageal reflux disease (GERD), hemorrhoids, hiatal hernia, melena, stomatitis and xerostomia.
Celexa citalopram antidepressant-SSRI Increased cough and gastroesophageal reflux have been reported , both of which can adversely affect the voice. Rarely, asthma, laryngitis, bronchospasm or sputum increase may occur.
Chantix varenicline nicotine receptor agonist Among the most common (> 5%, and twice the rate seen in placebo) adverse reactions to varenicline were constipation and flatulence. Other common adverse reactions (>= 1% and at least 0.5% more than placebo) include abdominal pain (including discomfort, tenderness, distension), anorexia, appetite stimulation, asthenia, dysgeusia, dyspepsia, dyspnea, gastroesophageal reflux , malaise, rhinorrhea, and xerostomia.
Cialis tadalafil ED-phosphodiesterase (PDE) type 5 inhibitor No effects on voice or speech mechanisms have been reported.
Cipro ciprofloxacin antibiotic-fluoroquinolone In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Claritin loratadine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Cleocin clindamycin antibiotic In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Climara estradiol hormone-estrogen topical No effects on voice or speech mechanisms have been reported.
Clomid clomiphene nonsteroidal fertility agent No effects on voice or speech mechanisms have been reported.
Codeine Sulfate codeine sulfate analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Combivent ipratropium/albuterol antiasthmatic-bronchodilation Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat man may lead to hoarseness, soreness, voice changes or laryngitis. Dry vocal tissues may be more prove to injuries, such as nodules.
Concerta methylphenidate stimulant Complaints of xerostomia or dysgeusia may be limited by sucking sugarless hard candy, crushed ice, and drinking plenty of water or other fluids.
Coreg carvedilol cardiovascular-alpha and beta blocker Beta-blockers can cause bronchospasm, dyspnea, or wheezing in patients with asthma or pulmonary disease . Non-selective beta-blockers such as carvedilol are more likely than selective agents to precipitate bronchospasm. Patients with preexisting bronchospastic disease are at greater risk. Two cases of death from status asthmaticus have been reported in patients receiving single doses of carvedilol. Rare post-marketing reports describing interstitial pneumonitis associated with carvedilol therapy do exist.
Coumadin warfarin anticoagulant Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Covera-hs verapamil cardiovascular-CCB Calcium channel blockers such as verapamil should be used cautiously in patients with gastroesophageal reflux disease (GERD) or hiatal hernia associated with reflux esophagitis. The drugs relax the lower esophageal sphincter. Note that voice production can be adversely affected by GERD.
Cozaar losartan cardiovascular-AGII antagonist An infrequently reported adverse reaction is coughing, which in turn, may cause hoarseness and possible vocal tissue damage.
Crestor rosuvastatin cardiovascular-statin The manufacturer provides the following adverse events which occurred in >= 2% of patients receiving rosuvastatin vs. placebo during pre-marketing trials (regardless of causality): pharyngitis (9% vs. 7.6% placebo), headache (5.5% vs. 5%), diarrhea (3.4% vs. 2.9%), dyspepsia (3.4% vs. 3.1%), nausea/vomiting (3.4% vs. 3.1%), muscle pain (2.8% vs. 1.3%), asthenia (2.7% vs. 2.6%), back pain (2.6% vs. 2.4%), flu-like syndrome (2.3% vs/ 1.8%), urinary tract infection (2.3% vs. 1.6%), rhinitis (2.2% vs. 2.1%), and sinusitis (2% vs. 1.8%).
Cycrin medroxyprogesterone hormone-progestin No effects on voice or speech mechanisms have been reported.
Cymbalta duloxetine antidepressant -Serotonin-Norepinephrine Reuptake Inhibitor Pharyngitis has been reported frequently during duloxetine administration (9% vs. 5% placebo). In clinical trials, cough was reported in 3—6% of those on duloxetine versus 3% of those receiving placebo.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Darvocet-n propoxyphene/acetaminophen analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Daypro oxaprozin analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Decadron dexamethasone steroid-glucocorticoid Dexamethaxone’s effect is advantageous when used shrink swollen vocal tissues, although patients taking dexamethasone should be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Deltasone prednisone steroid-glucocorticoid Prednisone’s effect is advantageous when used shrink swollen vocal tissues, although patients taking prednisone should be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Depakote valproic acid antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Depo-Testosterone testosterone cypionate hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Desyrel trazodone antidepressant No effects on voice or speech mechanisms have been reported.
Detrol tolterodine anticholinergic-overactive bladder Adverse effects consistent with the actions of antimuscarinic agents and reported in < 1% of patients treated with tolterodine in controlled clinical studies were confusion, gastroesophageal reflux , and flushing of the skin.
Dexadrine   dextroamphetamine      stimulant for ADHD Dextroamphetamine may have a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes and laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Diabeta glyburide antidiabetic-sulfonylurea No effects on voice or speech mechanisms have been reported.
Diflucan fluconazole antifungal No effects on voice or speech mechanisms have been reported.
Dilantin phenytoin antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Dilaudid hydromorphone analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Diovan valsartan cardivascular-AGII antagonist Excessive coughing has been associated with the use of ACE inhibitors, or to a lesser extent AGII inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Dolophine methadone analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Doryx doxycycline antibiotic-tetracycline In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Duragesic fentanyl analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Dyazide hydrochlorothiazide/triamterene cardiovascular-diuretic Diuretics have a drying effect on mucous membranes, including those used to speaking and singing. Hoarseness, sore throat, voice changes or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Effexor venlafaxine antidepressant-serotonin-norepinephrine reuptake inhibitor Effexor may have a drying effect on the body, including vocal fold tissues, which can lead to hoarseness, soreness, voice changes or laryngitis. Additionally, dry vocal tissues may b e more prone to injuries such as nodules.
Elavil amitriptyline antidepressant- TCA Tricyclic antidepressants may affect coordination, including the speech production system. Slow or slurred speech may be observed. They also have a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes or laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Eliquis (Pro) apixaban factor Xa inhibitors: anticoagulant Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased. 
Epogen (Pro) epoetin alfa recombinant human erythropoietins Transient ischemic attack-like symptoms including slurred speech, slow speech, inability to speak, and loss of voice have been reported.
Erytab erythromycin antibiotic-macrolide In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Eskalith lithium bipolar disorder-monovalent cation Dry mouth may occur with lithium treatment. Slurred speech may indicate need for dose adjustment.
Estrace estradiol hormone-estrogen No effects on voice or speech mechanisms have been reported.
Estraderm estradiol hormone-estrogen topical No effects on voice or speech mechanisms have been reported.
Estring estradiol vaginal ring hormone-estrogen No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Farxiga  dapagliflozin sodium-glucose cotransporter-2 inhibitors (SGLT2)  No effects on voice or speech mechanisms have been reported.
Fastin phentermine stimulant Dry mouth may occur.
Fioricet butalbital/APAP/caffeine analgesic-barbituate-pain combo Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Flagyl metronidazole antibiotic In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Flexeril cyclobenzaprine antispasmotic The use of muscle relaxers may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use. Muscle relaxers may affect coordination, including the speech production system. Slow or slurred speech may be observed. They also have a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes or laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Flomax tamsulosin BPH-alpha blocker Rarely, use of Flomax may cause pharyngitis (sore throat) or increased cough. Excessive coughing may lead to hoarseness and possible vocal tissue damage.
Flonase fluticasone antiallergy-steroid topical Throat irritation and dryness, cough, hoarseness and voice changes are all possible adverse reactions.
Flovent fluticasone antiallergy-steroid topical Patients using inhaled steroids sometimes experience voice changes (including complete loss of voice). The onset of symptoms and severity of symptoms is highly variable among patients. Studies show that discontinuation of inhaled steroids restores the voice in dysphonic patients, but symptoms may not resolve immediately.
Fortesta testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Fosamax alendronate osteoporosis-bisphosphonate Adverse effects with oral risedronate during the clinical trials were reported as generally mild and primarily affected the gastrointestinal system. The specific events reported are acid regurgitation (4.1%) including pyrosis (heartburn), flatulence (4.1%), gastroesophageal reflux disease (GERD) (0.7%), dyspepsia (3.4%), diarrhea (1.4%), abdominal pain (2.1%), and nausea (2.1% ).
Brand Name Generic Name Drug Class Effects on Voice or Speech
Gardasil HPV vaccine vaccine No effects on voice or speech mechanisms have been reported.
Geodon ziprasidone atypical antipsychotic Dry mouth may occur.
Glucophage metformin antidiabetic-oral biguanide agent No effects on voice or speech mechanisms have been reported.
Glucotrol glipizide antidiabetic-sulfonylurea No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Humalog insulin lispro antidiabetic-insulin No effects on voice or speech mechanisms have been reported.
Humira adalimumab biologic for immunosuppressive Cough, hoarseness, and loss of voice are all potential effects.
Humulin-N insulin isophane (human) antidiabetic-insulin No effects on voice or speech mechanisms have been reported.
Humulin-R insulin regular antidiabetic-insulin No effects on voice or speech mechanisms have been reported.
Hydrodiurel hydrochlorothiazide cardiovascular-diuretic Diuretics have a drying effect on mucous membranes, including those used to speaking and singing. Hoarseness, sore throat, voice changes or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries.
Hytrin terazosin cardiovascular-alpha blocker No effects on voice or speech mechanisms have been reported.
Hyzaar losartan/HCTZ cardiovascular-AGII antagonist/diuretic An infrequently reported adverse reaction is coughing, which in turn, may cause hoarseness and possible vocal tissue damage. Diuretics have a drying effect on mucous membranes, including those used to speaking and singing. Hoarseness, sore throat, voice changes or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Imdur isosorbide mononitrate cardiovascular-vasodilator Voice related effects may occur, including vocal tissue dryness (which, in addition to irritation effects, may be more prone to injuries, such as nodules). Bronchitis, bronchospasm and pharyngitis (sore throat) are other possible effects.
Imitrex sumatriptan antimigrane No effects on voice or speech mechanisms have been reported.
Inderal propranolol cardiovascular-beta blocker No effects on voice or speech mechanisms have been reported.
Indocin indomethacin analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Invokana canaglifluzin sodium-glucose cotransporter-2 inhibitors (SGLT2) No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Januvia sitagliptin antidiabetic-dipeptidyl-peptidase-IV (DPP-IV) inhibitors No effects on voice or speech mechanisms have been reported.
Jardiance empagliflozin sodium-glucose cotransporter-2 inhibitors (SGLT2) No effects on voice or speech mechanisms have been reported.
Jatenzo testosterone undecanoate hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Kariva desogestrel/ethinyl estradiol hormone-birth control The use of oral contraceptives has not been shown to significantly affect female voices.
Keflex cephalexin antibiotic-cephalosporin In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Keppra levetiracetam antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Klonopin clonazepam antianxiety-benzodiazepine Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Klor Con potassium chloride supplement No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Lamictal lamotrigine antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Lamisil terbinafine antifungal No effects on voice or speech mechanisms have been reported.
Lanoxin digoxin cardiovascular-digitalis inotropic agent No effects on voice or speech mechanisms have been reported.
Lantus insulin glargine antidiabetic-insulin No effects on voice or speech mechanisms have been reported.
Lasix furosemide cardiovascular-diuretic Diuretics have a drying effect on mucous membranes, including those used to speaking and singing. Hoarseness, sore throat, voice changes or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Lescol fluvastatin cardiovascular-statin No effects on voice or speech mechanisms have been reported.
Levaquin levofloxacin antibiotic-fluoroquinolone In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Levemir insulin detemir antidiabetic-insulin No effects on voice or speech mechanisms have been reported.
Levitra vardenafil ED-phosphodiesterase (PDE) type 5 inhibitor Gastrointestinal (GI) adverse reactions occurring in at least 2% of patients taking vardenafil film-coated tablets and more frequently than placebo included dyspepsia (4% vs 1%) and nausea/vomiting (2% vs 1%). Dyspepsia also occurred in 2.8% of patients receiving the orally disintegrating tablets. GI effects that occurred in less than 2% of patients included abdominal pain, diarrhea, dysphagia, esophagitis, gastritis, gastroesophageal reflux , vomiting, and xerostomia.
Levothroid levothyroxine hormone-thyroid replacement No effects on voice or speech mechanisms have been reported.
Levoxyl levothyroxine hormone-thyroid replacement No effects on voice or speech mechanisms have been reported.
Lexapro escitalopram antidepressant-SSRI Xerostomia occurred in 4% of patients receiving 10 mg, versus 3% on placebo. Xerostomia (9%) at least doubled in incidence when the 20 mg dose was utilized.
Lipitor atorvastatin cardiovascular-statin No effects on voice or speech mechanisms have been reported.
Lodine etodolac analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Lopid gemfibrizil cardiovscular-lipid reduction No effects on voice or speech mechanisms have been reported.
Lopressor metoprolol tartrate cardiovascular-beta blocker No effects on voice or speech mechanisms have been reported.
Lortab hydrocodone/acetaminophen analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Lotensin benazepril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Lotrel amolodipine/benazepril cardiovascular-CCB/ACEi combo Calcium channel blockers such as amolodipine should be used cautiously in patients with gastroesophageal reflux disease (GERD) or hiatal hernia associated with reflux esophagitis. The drugs relax the lower esophageal sphincter. Note that voice production can be adversely affected by GERD. Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Lotrisone clotrimoxazole/betamethasone antifungal/steroid topical No effects on voice or speech mechanisms have been reported.
Lovaza omega-3-acid ethyl esters omega 3 fatty acid No effects on voice or speech mechanisms have been reported.
Lumigan bimatoprost antiglaucoma-synthetic prostamide No effects on voice or speech mechanisms have been reported.
Lunesta eszopiclone sedative/hypnotic The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Lupron leuprolide hormonal antaganist No effects on voice or speech mechanisms have been reported.
Lyrica pregabalin antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Macrobid nitrofurantoin antibiotic-nitrofuran In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Medrol methylprednisolone steroid-glucocorticoid Methylprednisolone’s effect is advantageous when used shrink swollen vocal tissues, although patients taking methylprednisolone should be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Mevacor lovastatin cardiovascular-statin No effects on voice or speech mechanisms have been reported.
Miacalcin calcitonin salmon osteoporosis- Adverse reactions reported by 3% or more patients using intranasal calcitonin were rhinitis (12%), nasal symptoms (12%), epistaxis (3.5%), headache (3.2%), and sinusitis (2.3%). Nasal symptoms were the most commonly reported and cover a wide variety of symptoms such as crusting, nasal dryness, redness or erythema, infection, itching, nasal congestion, stenosis, and uncomfortable feeling and soreness across the bridge of the nose. Nasal irritation is mild to moderate in 95% of cases. Nasal symptoms were often only reported once and usually improved with continued use or discontinuation.
Micardis telemisartan angiotensin II Receptor Blocker    No effects on voice or speech mechanisms have been reported.
Micronase glyburide antidiabetic-sulfonylurea No effects on voice or speech mechanisms have been reported.
Miralax polyethylene glycol 3350 laxative-osmotic No effects on voice or speech mechanisms have been reported.
Mirapex pramipexole antiparkinson-dopamine agonist Dry mouth may occur.
Mircera epoetin beta-methoxy polyethylene glycol Recombinant human erythropoietins Transient ischemic attack-like symptoms including slurred speech, slow speech, inability to speak, and loss of voice have been reported.
Mirena levonorgestrel-releasing intruterine system hormone-birth control The use of oral contraceptives has not been shown to significantly affect female voices.
Mobic meloxicam analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage. Less common GI effects (< 1% incidence) that occurred with meloxicam regardless of causality included: colitis, xerostomia (dry mouth), peptic ulcer disease (duodenal or gastric ulcer), eructation, gastritis, gastroesophageal reflux, GI bleeding (hemorrhagic duodenal or gastric ulcer), hematemesis, melena, pancreatitis, GI perforation (perforated duodenal or gastric ulcer, intestinal perforation), and stomatitis, including oral ulceration.
Monopril fosinopril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Motrin ibuprofen analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
MS-Contin morphine sulfate analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Myrbetriq mirabegron beta-3 adrenergic agonist has a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes or laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Naprosyn naproxen analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Nasonex mometasone antiallergy-steroid topical Throat irritation and dryness, cough, hoarseness and voice changes are all possible adverse reactions. Rarely, oral or nasal candidiasis may occur.
Natesto testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Nebiovlol  bystolic beta blocker No effects on voice or speech mechanisms have been reported.
Nesinsa alogliptin dipeptidyl peptidase 4 inhibitor for diabetes mellitus 2 Cough and loss of voice are possible effects.
Neurontin gabapentin antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Nexium esomeprazole proton pump inhibitor These agents have a favorable effect on the voice in that they reduce damage of gastrointestinal reflux (GERD). Uncontrolled acidic spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Nitrostat nitroglycerin cardiovascular-nitrate-vasodilation No effects on voice or speech mechanisms have been reported.
Nolvadex tamoxifen hormone-antiestrogen No effects on voice or speech mechanisms have been reported.
Norco hydrocodone/acetaminophen analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Norvasc amlodipine cardiovascular-CCB Calcium channel blockers such as amlodipine should be used cautiously in patients with gastroesophageal reflux disease (GERD) or hiatal hernia associated with reflux esophagitis. The drugs relax the lower esophageal sphincter. Note that voice production can be adversely affected by GERD.
Nuvaring etonogestrel/ethinyl estradiol vaginal ring hormone-birth control The use of oral contraceptives has not been shown to significantly affect female voices.
Nystatin nystatin antifungal No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Omnicef  cefdinir cephalosporin antibiotic  No effects on voice or speech mechanisms have been reported.
Omontys peginesatide recombinant human erythropoietins Transient ischemic attack-like symptoms including slurred speech, slow speech, inability to speak, and loss of voice have been reported.
Onglyza saxagliptin dipeptidyl peptidase 4 inhibitors for diabetes mellitus 2 Cough and loss of voice are possible effects.
Oxycontin oxycodone analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Ozempic semaglutide gastrointestinal-H2 blocker Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether this is true for humans. However, exenatide extended-release is contraindicated in patients with a personal or family history of medullary thyroid cancer and in patients with Multiple Endocrine Neoplasia syndrome. The earlier medullary thyroid cancer is found, the more likely it can be stopped and treated. Unfortunately, there may be no early warning signs; noticeable signs and symptoms like hoarseness, difficulty swallowing, or throat lumps often don’t appear until the tumor has advanced.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Paxil paroxetine antidepressant-SSRI Paxil may have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Penicillin-vk penicillin antibiotic-penicillin In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Pepcid famotidine gastrointestinal-H2 blocker Two effects exist: 1) the antihistamine component has a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more prone to injuries, such as nodules. 2) However, this medication may benefit the voice if it is taken to reduce acidity of gastroesophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Percocet oxycodone/acetaminophen analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Phenergan promethazine antinausea-phenothiazine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Plan-b levonorgestrel hormone-birth control The use of oral contraceptives has not been shown to significantly affect female voices.
Plavix clopidogrel cardiovascular-platelet aggregation inhibitor Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Plendil felodipine cardiovascular-calcium channel blocker No effects on voice or speech mechanisms have been reported.
Pravachol pravostatin cardiovascular-statin No effects on voice or speech mechanisms have been reported.
Prednisone prednisone steroid-glucocorticoid Prednisone’s effect is advantageous when used shrink swollen vocal tissues, although patients taking prednisone should be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Premarin congugated estrogens hormone-estrogen No effects on voice or speech mechanisms have been reported.
Prempro congugated estrogens/medroxyprogesterone hormone-estrogen/progestin combo No effects on voice or speech mechanisms have been reported.
Prevacid lansoprazole proton pump inhibitor These agents have a favorable effect on the voice in that they reduce damage of gastrointestinal reflux (GERD). Uncontrolled acidic spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Prilosec omeprazole proton pump inhibitor These agents have a favorable effect on the voice in that they reduce damage of gastrointestinal reflux (GERD). Uncontrolled acidic spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Prinivil lisinopril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Procardia nifedipine cardiovascular-calcium channel blocker No effects on voice or speech mechanisms have been reported.
Procrit epoetin alfa recombinant human erythropoietins Transient ischemic attack-like symptoms including slurred speech, slow speech, inability to speak, and loss of voice have been reported.
Prometrium progesterone hormone-progestin No effects on voice or speech mechanisms have been reported.
Protonix pantoprazole proton pump inhibitor These agents have a favorable effect on the voice in that they reduce damage of gastrointestinal reflux (GERD). Uncontrolled acidic spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Proventil albuterol antiasthmatic-bronchodilation Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat man may lead to hoarseness, soreness, voice changes or laryngitis. Dry vocal tissues may be more prove to injuries, such as nodules.
Provera medroxyprogesterone hormone-progestin No effects on voice or speech mechanisms have been reported.
Provigil modafinil stimulant Bronchospasm (i.e., asthma), dyspnea, epistaxis, pharyngitis , rhinitis may occur.
Prozac fluoxetine antidepressant-SSRI Prozac may have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Pulmicort-respules budesonide antiasthmatic-steroid inhaled Patients using inhaled steroids sometimes experience voice changes (including complete loss of voice). The onset of symptoms and severity of symptoms is highly variable among patients. Studies show that discontinuation of inhaled steroids restores the voice in dysphonic patients, but symptoms may not resolve immediately.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Reglan metoclopramide antinausea-phenothiazine Pseudoparkinsonism may develop including bradykinesia, tremor, cogwheel rigidity, and mask-like facies. The parkinsonian-like symptoms generally subside within 2—3 months following the discontinuation of metoclopramide. Tardive dyskinesia has been reported with long-term and high-dose use and especially among patients being treated for longer than 3 months. Tardive dyskinesia includes symptoms such as repetitive and involuntary movements of the extremities, lip smacking, grimacing, tongue protrusion, rapid eye movements, blinking, puckering and pursing of the lips, or impaired movement of the fingers. The symptoms are often irreversible and there is no known treatment. Tardive dyskinesia occurs more frequently in elderly patients, especially females. Although tardive dyskinesia is more likely to occur after prolonged therapy or high dosage, relatively brief therapy has been associated with this effect as well.
Relafen nabumetone analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Remeron mirtazepine antidepressant-piperazinoazepines Dry mouth may occur.
Restoril temazepam sedative/hypnotic The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Retacrit epoetin alfa recombinant human erythropoietins Transient ischemic attack-like symptoms including slurred speech, slow speech, inability to speak, and loss of voice have been reported.
Rhinocort-Aqua budesonide antiallergy-steroid topical Throat irritation and dryness, cough, hoarseness and voice changes are all possible adverse reactions. Rarely, oral or nasal cadidiasis may occur.
Risperdal risperadone atypical antipsychotic Risperdal may have adverse effects on speech, including difficulty in articulating words.
Ritalin methylphenidate stimulant Complaints of xerostomia or dysgeusia may be limited by sucking sugarless hard candy, crushed ice, and drinking plenty of water or other fluids.
Robaxin methocarbamol antispasmotic Muscle relaxants have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules. The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Roxicodone oxycodone analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Savaysa edoxaban factor Xa inhibitors:  anticoagulant Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased. 
Septra sulfamethox/trimethoprin antibiotic-sulfa In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Serevent salmeterol antiasthmatic-bronchodilation Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat man may lead to hoarseness, soreness, voice changes or laryngitis. Dry vocal tissues may be more prove to injuries, such as nodules.
Seroquel quetiapine atypical antipsychotic Among the most frequent adverse events associated with the use of quetiapine is xerostomia . In clinical trials for schizophrenia, xerostomia was reported in 7% of patients receiving immediate-release quetiapine. In clinical trials of immediate-release quetiapine, rhinitis was reported in 3% of quetiapine treated patients, and was among adverse effects that occurred in more than 2% of patients treated with active drug and were reported more frequently than in placebo-treated patients. Treatment-emergent adverse effects as reported in clinical trials of patients with bipolar depression which occurred in at least 5% of patients and with an incidence greater than placebo included nasal congestion (5% vs. 3%).
Serzone nafazodone antidepressant No effects on voice or speech mechanisms have been reported.
Sinemet carbodopa/levodopa antiparkinson-dopamine agonist Dyskinesia and sporadic movements are the most common of the serious effects of carbidopa; levodopa therapy and include choreiform reaction and dystonic reaction. These effects occur in up to 80% of patients receiving levodopa therapy for >= 3 years. Involuntary movements, including chewing, bruxism, gnawing, twisting, protrusion of the tongue, opening and closing the mouth, bobbing of the head, rhythmic movements of the feet or hands, quick movements of the shoulder, and ballismus, have been reported and may necessitate dosage reduction. Blepharospasm (which may indicate toxicity), muscle twitching, ataxia, myoclonia during sleep, and hand tremor also have been reported.
Singulair montelukast antiasthmatic-leukotriene receptor antagonist No effects on voice or speech mechanisms have been reported.
Skelaxin metaxalone antispasmotic No effects on voice or speech mechanisms have been reported. The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Soma carisoprodol antispasmotic No effects on voice or speech mechanisms have been reported. The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Spiriva tiotropium anticholinergic-COPD The incidence of xerostomia with tiotropium use is roughly 10%. As with most anticholinergic agents, constipation may occur if significant amounts of tiotropium are absorbed. Post-marketing reports indicate that other gastrointestinal related effects have occurred including dysphagia, epistaxis, hoarseness, GI obstruction (e.g., paralytic ileus), oral candidiasis, and throat irritation although the exact incidences of these adverse reactions have not been established.
Strattera atomoxetine stimulant Dry mouth may occur.
Steglatro ertugliflozine Sodium glucose Cotransporter-2 inhibitor for diabetes mellitus No effects on voice or speech mechanisms have been reported.
Strattera atomoxetine  for ADHD (unknown mechanism) may have a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes and laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Suboxone buprenorphine/naloxone analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Sumycin tetracycline antibiotic-tetracycline In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Synthroid levothyroxine hormone-thyroid replacement Thyroid hormone receptors have been identified in the laryngeal tissue and the thyroid hormone plays an important role in the development of the larynx. Thyroid hormone excess rarely leads to hoarseness of voice due to the stuttering movement of the vocal cords.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Tagamet cimetidine gastrointestinal-H2 blocker Two effects exist: 1) the antihistamine component has a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more prone to injuries, such as nodules. 2) However, this medication may benefit the voice if it is taken to reduce acidity of gastroesophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Tamiflu oseltamivir antiviral No effects on voice or speech mechanisms have been reported.
Tegretol carbemazepine antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Tenex guanfacine antiadrenergic agents, centrally acting  Guanfacine may have a drying effect on vocal fold tissues, which can lead to hoarseness, soreness, voice changes and laryngitis. Additionally, dry vocal tissues may be more prone to injuries such as nodules.
Tenormin atenolol cardiovascular-beta blocker No effects on voice or speech mechanisms have been reported.
Testim testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Testopel testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Tiazac diltiazem cardiovascular-calcium channel blocker No effects on voice or speech mechanisms have been reported.
Timoptic timolol ophthalmic antiglaucoma-beta blocker No effects on voice or speech mechanisms have been reported.
Topamax topiramate antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Toprol-XL metoprolol succinate cardiovascular-beta blocker No effects on voice or speech mechanisms have been reported.
Toradol ketorolac analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Tradjenta linagliptin Dipeptidyl peptidase 4 inhibitor  
Treximet sumatriptan/naproxen migraine treatment Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Tricor fenofibrate cardiovascular-fibrate No effects on voice or speech mechanisms have been reported.
Trileptal oxcarbazepine antiseizure Anticonvulsants may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to their use.
Trulicity Dulaglutide Glucagon-like peptide-1 for diabetes mellitus 2 Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether this is true for humans. However, exenatide extended-release is contraindicated in patients with a personal or family history of medullary thyroid cancer and in patients with Multiple Endocrine Neoplasia syndrome. The earlier medullary thyroid cancer is found, the more likely it can be stopped and treated. Unfortunately, there may be no early warning signs; noticeable signs and symptoms like hoarseness, difficulty swallowing, or throat lumps often don’t appear until the tumor has advanced.
Trusopt dorzolamide ophth sol anti glaucoma The possibility of systemic adverse reactions to dorzolamide is small, but there have been occasional reports of headache, nausea, asthenia, fatigue, skin rash, and urolithiasis. Contact dermatitis, xerostomia (dry mouth), epistaxis, and throat irritation have been reported during post-market surveillance.
Tussionex hydrocodone/guifenesin analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Tylenol acetaminophen analgesic No effects on voice or speech mechanisms have been reported.
Tylenol-codeine acetaminophen/codeine analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Ultracet tramadol/acetaminophen analgesic No effects on voice or speech mechanisms have been reported.
Ultram tramadol analgesic No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Valium diazepam antianxiety-benzodiazepine Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Valtrex valacyclovir antiviral No effects on voice or speech mechanisms have been reported.
vancomycin vancomycin antibiotic-glycopeptide In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Vasotec enalapril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Viagra sildenafil ED-phosphodiesterase (PDE) type 5 inhibitor Adverse reactions affecting hearing or otic special senses and occurring in < 2% of patients in controlled clinical trials of sildenafil include hearing loss, otalgia, and tinnitus. In addition, 29 reports of sudden changes in hearing including hearing loss or decrease in hearing, usually in 1 ear only, have been reported to the FDA during post-marketing surveillance in patients taking sildenafil, tadalafil, or vardenafil; the reports are associated with a strong temporal relationship to the dosing of these agents. Many times, the hearing changes are accompanied by vestibular effects including dizziness, tinnitus, and vertigo. Follow-up has been limited in many of the reports; however, in approximately one-third of the patients, the hearing loss was temporary. Concomitant medical conditions or patient factors may play a role, although risk factors for the onset of sudden hearing loss have not been identified. Patients should be instructed to contact their physician if they experience changes in hearing.
Vicodin hydrocodone/acetaminophen analgesic-narcotic Narcotics may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to narcotic use.
Victoza Liraglutide Glucagon-like peptide-1 for diabetes mellitus 2 Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether this is true for humans. However, exenatide extended-release is contraindicated in patients with a personal or family history of medullary thyroid cancer and in patients with Multiple Endocrine Neoplasia syndrome. The earlier medullary thyroid cancer is found, the more likely it can be stopped and treated. Unfortunately, there may be no early warning signs; noticeable signs and symptoms like hoarseness, difficulty swallowing, or throat lumps often don’t appear until the tumor has advanced.
Vistaril hydroxyzine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Vogelxo testosterone hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Voltaren diclofenac analgesic-NSAID Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Vytorin simvastatin/ezetimibe cardiovascular-statin/lipid reduction No effects on voice or speech mechanisms have been reported.
Vyvanse lisdexamfetamine stimulant Dry mouth may occur.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Wellbutrin buproprion antidepressant-aminoketone No effects on voice or speech mechanisms have been reported.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Xalatan latanoprost antiglaucoma-synthetic prostamide No effects on voice or speech mechanisms have been reported.
Xanax alprazolam antianxiety-benzodiazepine Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Xarelto rivaroxaban factor Xa inhibitors: anticoagulant Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenuous voicing demands, due to an increased 
Xenical orlistat gastrointestinal lipase inhibitor No effects on voice or speech mechanisms have been reported.
Xyosted testosterone enanthate hormone replacement therapy Testosterone will cause a thickening of the vocal cords, which will result in a more male-sounding voice. Voice changes may begin within a few weeks, with a scratchy sensation in the throat or hoarseness. 1-10% of patients experience sinusitis, nasopharyngitis, upper respiratory tract infection, or bronchitis. Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis, gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, or taste perversion may also occur.
Xyzal levocetirizine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Brand Name Generic Name Drug Class Effects on Voice or Speech
Zanaflex tizanidine antispasmotic Dry mouth may occur. The use of sedatives may produce an uninhibited or diminished drive to speak. Symptoms of dysarthria (slow, slurred and uncoordinated speech movements) may also be linked to sedative use.
Zantac ranitidine gastrointestinal-H2 blocker Two effects exist: 1) the antihistamine component has a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more prone to injuries, such as nodules. 2) However, this medication may benefit the voice if it is taken to reduce acidity of gastroesophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Zebeta bisoprolol beta-blocker No effects on voice or speech mechanisms have been reported.
Zestoretic lisinopril/HCTZ cardiovascular-ACE inhibitor/diuretic Two adverse reactions are possible: 1) excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage; and 2) the diuretic component may have a drying effect on mucous membranes, including those used for speaking and singing. Hoarseness, sore throat, voice changes and laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Zestril lisinopril cardiovascular-ACE inhibitor Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possibly vocal tissue damage.
Zetia ezetimibe cardiovascular-lipid reduction No effects on voice or speech mechanisms have been reported.
Ziac bisoprolol/HCTZ cardiovascular-beta blocker/diuretic Diuretics have a drying effect on mucous membranes, including those used to speaking and singing. Hoarseness, sore throat, voice changes or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries.
Zithromax azithromycin antibiotic-macrolide In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse/misuse can lead to an overgrowth of Candida in the body, possibly leading to laryngeal thrush.
Zocor simvastatin cardiovascular-statin No effects on voice or speech mechanisms have been reported.
Zoloft sertraline antidepressant-SSRI Zoloft may have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.
Zovirax acyclovir antiviral No effects on voice or speech mechanisms have been reported.
Zyban buproprion antidepressant-aminoketone No effects on voice or speech mechanisms have been reported.
Zyloprim allopurinol antigout No effects on voice or speech mechanisms have been reported.
Zyprexa olanzepine atypical antipsychotic Infrequent effects may include coughing, pharyngitis (sore throat), or (non-defined) voice alterations.
Zyrtec cetirizine antihistamine Antihistamines have a drying effect on mucous membranes that may cause hoarseness, sore throat, voice changes or laryngitis. In addition to irritation, dry vocal folds may be more proven to injuries, such as nodules.