Information - for Vocologists

Frequently Prescribed Medications and Effects on Voice and Speech

More than 200 of the most frequently prescribed medications in the U.S.are listed in alphabetical order (Column 1). Columns 2, 3 and 4 provide additional information about each medication. Column 5 describes any known effect on voice or speech.

In general, groups of drugs have documented negative effects on the vocal system are androgens, anabolic steroids, central nervous system stimulants, sedatives, narcotics, tricyclic antidepressants, inhaled steroids, antihistamines, some cardiovascular drugs, and rarely, antianxiety agents (benzodiazepines). Other medications, such as hydrating agents, steroids and agents used for gastro-esophageal reflux, may have favorable effects on voicing or speech. As noted below, however, about half of the top 200 prescribed medications have neither adverse nor beneficial effects on voice or speech production.

Of course, 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.). Specific questions should be directed to a personal physician or pharmacist.

Brand Name	Manufacturer	Generic Name	Drug Group	Effect on Voice
Accolate	Zeneca	Zafirlukast	antiasthmatic	No effects on voice or speech mechanisms have been reported.
Accupril	Parke-Davis	Quinapril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Acetaminophen/ Codeine	various	Acetaminophen/ Codeine	narcotic analgesic	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.
Adalat CC	Bayer Pharm	Nifedipine	cardiovascular - calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Adderall	Shire Rchwd	Amphetamine Mixed Salts	central nervous system stimulant	Adderall may 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.
Albuterol Aerosol	various	Albuterol	antiasthmatic/ bronchodilator	Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat and may lead to hoareseness, soreness, voice changes or laryngititis. Dry vocal tissues may be more prone to injuries, such as nodules, as well.
Alesse 28	Wyeth-Ayerst	Levonorgestrel/ Ethinyl Estradiol	hormone oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Allegra	Hoech Mar R	Fexofenadine	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 prone to injuries, such as nodules.
Allopurinol	various	Allopurinol	antigout	No effects on voice or speech mechanisms have been reported.
Alprazolam	various	Alprazolam	antianxiety/ benzodiazepine	Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Altace	Hoech Marion Roussel	Ramipril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Amaryl	Hoech Mar R	Glimepiride	antidiabetic	No effects on voice or speech mechanisms have been reported.
Ambien	Searle	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.
Amitriptyline	various	Amitriptyline	tricyclic antidepressant	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.
Amoxicillin	various	Amoxicillin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Aricept	Eisai	Donepezil	cholinergic function enhancer for Alzheimer's patients	Infrequent voice and speech effects may include include tongue edema, pharyngitis and bronchitis.
Arthrotec	Searle	Diclofenac/ Misoprostol	nonsteroidal anti-inflammatory	Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Atenolol	various	Atenolol	cardiovascular - beta blocker	No effects on voice or speech mechanisms have been reported.
Atrovent Inhaler	Boehringer lngelheim	Ipratropium	antiasthmatic/ antiallergy	Inhaled antiasthmatic medications sometimes dry or irritate tissues in the mouth and throat and may lead to hoareseness, soreness, voice changes or laryngititis. Dry vocal tissues may be more prone to injuries, such as nodules, as well.
Augmentin	SmithKline Beecham	Amoxicillin/ Clavulanate	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Avapro	Bristol-Myers Squibb	Irbesartan	ACE Inhibitor	Although excessive coughing has been associated with the use of ACE inhibitors, which may lead to hoarseness and possible vocal tissue damage, this effect has NOT been associated with Avapro.
Axid	Lilly	Nizatidine	gastrointestinal H2 antihistamine	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 gastro-esophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Azmacort	Rhn-Plnc Rr	Triamcinolone aerosol	antiasthmatic/ steroid (inhaled)	Patients using inhaled steroids sometimes experience significant 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.
Bactroban	SmithKline Beecham	Mupirocin	topical antibacterial	No effects on voice or speech mechanisms have been reported.
Biaxin	Abbott	Clarithromycin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
BuSpar	Bristol-Myers Squibb	Buspirone	antianxiety	No effects on voice or speech mechanisms have been reported.
Cardizem CD	Hoech Mar R	Diltiazem	cardiovascular - calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Cardura	Pfizer	Doxazosin	cardiovascular - alpha blocker	No effects on voice or speech mechanisms have been reported.
Carisoprodol	various	Carisoprodol	muscle relaxant	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.
Ceftin	Glaxo Wellcome	Cefuroxime	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Cefzil	Bristol-Myers Squibb	Cefprozil	antibiotic
Celexa	Forest Pharm	Citalopram	antidepressant	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.
Cephalexin	various	Cephalexin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Cimetidine	various	Cimetidine	gastrointestinal - H2 antihistamine	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 gastro-esophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Cipro	Bayer Pharm	Ciprofloxacin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Claritin, Claritin D 12HR, Claritin D 24HR	Schering	Loratadine or Loratidine/ Pseudoephedrine	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 prone to injuries, such as nodules.
Climara	Berlex	Estradiol	hormone - estrogen/ topical	No effects on voice or speech mechanisms have been reported.
Clonazepam	various	Clonazepam	anticonvulsant	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.
Clonidine	various	Clonidine	antihypertensive	No effects on voice or speech mechanisms have been reported.
Combivent	Boehr Ingel	Ipratropium/ Albuterol	antiasthmatic/ bronchodilator	Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat and may lead to hoareseness, soreness, voice changes or laryngititis. Dry vocal tissues may be more prone to injuries, such as nodules, as well.
Coumadin	Dupont	Warfarin	anticoagulant	Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Cozaar	Merck	Losartan	cardiovascular angiotension II antagonist	An infrequently-reported adverse reaction is coughing, which in turn, may cause hoarseness and possible vocal tissue damage.
Cyclobenzaprine	various	Cyclobenzaprine	muscle relaxant	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. This medication may 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.
Cycrin	ESI Lederle	Medroxy- progesterone	hormone - progestin	No effects on voice or speech mechanisms have been reported.
Daypro	Searle	Oxaprozin	nonsteroidal antiinflammatory	Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Deltasone	Pharmacia/ Upjohn	Prednisone	antiinflammatory/ steroid	Deltasone's effect is advantageous when used to shrink swollen vocal tissues, although patients taking Deltasone should be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Depakote	Abbott	Divalproex	anticonvulsant	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.
Desogen	Organon	Desogestrel /EthinylEstradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Diazepam	various	Diazepam	antianxiety/ benzodiazepine	Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Diflucan	Pfizer	Fluconazole	antifungal	No effects on voice or speech mechanisms have been reported.
Dilantin	Parke-Davis	Phenytoin	anticonvulsant	Slurred speech and other speech coordination tasks are possible adverse reactions to Dilantin use.
Diovan	Novartis	Valsartan	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Dyazide	SmithKline Beecham	Hydrochlorothiazide/ Triamterine	diuretic combination	Diuretics have a drying effect on mucous membranes, including those used for 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.
Effexor	Wyeth-Ayerst	Venlafaxine	antidepressant	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 be more prone to injuries such as nodules.
Elocon	Schering	Mometasone	topical steroid	No effects on voice or speech mechanisms have been reported.
Endocet	Endo	Oxycodone/APAP	narcotic analgesic	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.
Ery-Tab	Abbott	Erythromycin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Estrace	B-M Squibb	Estradiol	hormone - estrogen	No effects on voice or speech mechanisms have been reported.
Estraderm	Novartis	Estradiol	hormone - estrogen/ patch	No effects on voice or speech mechanisms have been reported.
Estradiol	various	Estradiol	hormone - estrogen	No effects on voice or speech mechanisms have been reported.
Flomax	Abbott	Tamsulosin	benign prostatic hypertrophy agent	Rarely, use of Flomax may cause pharyngitis or increased cough. Excessive coughing may lead to hoarseness and possible vocal tissue damage.
Flonase	Glaxo Wellcome	Fluticasone	steroid decongestant (nasal spray)	Throat irritation and dryness, cough, hoarseness and voice changes are all possible adverse reactions.
Flovent	Glaxo Wellcome	Fluticasone Propionate	steroid decongestant (oral)
Folic Acid	Schein	Folic Acid	Vitamin/mineral supplement	No effects on voice or speech mechanisms have been reported.
Fosamax	Merck	Alendronate	osteoporosis agent	No effects on voice or speech mechanisms have been reported.
Furosemide	various	Furosemide	loop diuretic	Diuretics have a drying effect on mucous membranes, including those used for 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.
Gemfibrozil	various	Gemfibrozil	antihyperlipidemic	No effects on voice or speech mechanisms have been reported.
Glipizide	various	Glipizide	antidiabetic	No effects on voice or speech mechanisms have been reported.
Glucophage	B-M Squibb	Metformin	antidiabetic	No effects on voice or speech mechanisms have been reported.
Glucotrol XL	Pfizer	Glipizide	antidiabetic	No effects on voice or speech mechanisms have been reported.
Glyburide	various	Glyburide	antidiabetic	No effects on voice or speech mechanisms have been reported.
Guaifenesin	various	Guaifenesin	expectorant	Guaifenesin may have a beneficial effect on vocal tissues, as it helps keep vocal folds well-hydrated when used with plenty of water intake.
Humulin 70/30, Humulin N, Humulin R	Lilly	Human Insulin	antidiabetic	No effects on voice or speech mechanisms have been reported.
Hydro- chlorothiazide	various	Hydrochlorothiazide	thiazide diuretic	Diuretics have a drying effect on mucous membranes, including those used for 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.
Hydrocodone w/APAP	various	Hydrocodone w/APAP	narcotic analgesic	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.
Hytrin	Abbott	Terazosin	cardiovascular - alpha blocker	No effects on voice or speech mechanisms have been reported.
Hyzaar	Merck	Losartan/HCTZ	cardiovascular - ACE inhibitor thiazide 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 or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Ibuprofen	various	Ibuprofen	nonsteroidal anti-inflammatory	Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Imitrex	Glaxo Wellcome	Sumatriptan	antimigrainous agent	No effects on voice or speech mechanisms have been reported.
Isosorbide Mononitrate	various	Isosorbide Mononitrate	antianginal	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 are other possible effects.
K-Dur-20	Schering	Potassium Chloride	potassium supplement	No effects on voice or speech mechanisms have been reported.
Klor-Con	Upsher-Smith	Potassium Chloride	potassium supplement	No effects on voice or speech mechanisms have been reported.
Lamisil	Novartis	Terbinafine	antifungal	No effects on voice or speech mechanisms have been reported.
Lanoxin	Glaxo Wellcome	Digoxin	cardiovascular - inotropic	No effects on voice or speech mechanisms have been reported.
Lasix	Hoech Mar R	Furosemide	loop diuretic	Diuretics have a drying effect on mucous membranes, including those used for 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	Novartis	Fluvastatin	antihyperlipidemic	No effects on voice or speech mechanisms have been reported.
Levaquin	Ortho Pharm	Levofloxacin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Levoxyl	Jones Pharma	Levothyroxine	hormone - thyroid	No effects on voice or speech mechanisms have been reported.
Lipitor	Parke-Davis	Atorvastatin	antihyperlipidemic	No effects on voice or speech mechanisms have been reported.
Lo/Ovral 28	Wyeth-Ayerst	Norgestrel/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Loestrin- FE 1.5/30	Parke-Davis	Norethindrone/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Loestrin- Fe 1/20	Parke-Davis	Norethindrone/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Lorabid	Lilly	Loracarbef	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Lorazepam	various	Lorazepam	antianxiety/ benzodiazepine	Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Lotensin	Novartis	Benazepril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Lotrel	Novartis	Amlodipine/ Benazepril	cardiovascular - calcium channel blocker/ ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Lotrisone	Schering	Clotrimoxazole/ Betamethasone	topical antifungal	No effects on voice or speech mechanisms have been reported.
Macrobid	Procter & Gamble	Nitrofurantoin	antibacterial	In general, no effects on voice or speech mechanisms are associated with its use. It should be noted, however, that abuse of this agent can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Medroxy progesterone	various	Medroxy progesterone	hormone - progestin	No effects on voice or speech mechanisms have been reported.
Methyl prednisolone	various	Methyl prednisolone	antiinflammatory/ steroid	Methyl prednisolone's effects are beneficial when used to shrink swollen vocal tissues, although patients taking it should be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Metoprolol Tartrate	various	Metoprolol	cardiovascular - beta blocker	No effects on voice or speech mechanisms have been reported.
Mevacor	Merck	Lovastatin	antihyperlipidemic	No effects on voice or speech mechanisms have been reported.
Miacalcin Nasal	Novartis	Calcitonin Salmon	osteoporosis agent	No effects on voice or speech mechanisms have been reported.
Monopril	Bristol-Myers Squibb	Fosinopril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Naproxen	various	Naproxen	nonsteroidal antiinflammatory	Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Nasonex	Schering	Mometasone	steroid decongestant nasal spray	Throat irritation and dryness, cough, hoarseness and voice changes are all possible adverse reactions. Rarely, oral or nasal candidiasis may occur.
Necon 1/35	Watson Lab	Norethindrone/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Neomycin/ Polymx/HC	various	Neomycin/ Polymx/HC	topical antibiotic - steroid combo	No effects on voice or speech mechanisms have been reported.
Neurontin	Parke-Davis	Gabapentin	anticonvulsant	Neurotonin 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 be more prone to injuries such as nodules.
Nitrostat	Parke-Davis	Nitroglycerin	antianginal	No effects on voice or speech mechanisms have been reported.
Norvasc	Pfizer	Amlodipine	cardiovascular - calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Ortho Tri-Cyclen	Ortho Pharm	Norgestimate/ Ethinyl Estradiol	hormone oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Ortho-Cept	Ortho Pharm	Desogestrel/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Ortho-Cyclen	Ortho Pharm	Norgestimate/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Ortho-Novum 7/7/7	Ortho Pharm	Norethindrone/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Oxycodone/ Acetaminophen	Mallinckrodt	Oxycodone/APAP	analgesic	No effects on voice or speech mechanisms have been reported.
Oxycontin	Purdue	Oxycodone	analgesic	No effects on voice or speech mechanisms have been reported.
Paxil	SmithKline Beecham	Paroxetine	antidepressant	Paxil 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 be more prone to injuries such as nodules.
Penicillin VK	various	Penicillin VK	antibotic	No effects on voice or speech mechanisms have been reported.
Pepcid	Merck	Famotidine	gastrointestinal - H2 antagonist	Pepcid has a favorable effect on the voice in that it reduces esophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Phenergan Supp	Wyeth-Ayerst	Promethazine	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 prone to injuries, such as nodules.
Plavix	Sanofi	Clopidogrel	platelet aggregation inhibitor	Those who use their voices rigorously should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage. Bronchitis and coughing may occur; excess coughing may lead to hoarseness and possible vocal tissue damage.
Plendil	Astra	Felodipine SR	cardiovascular calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Potassium Chloride	various	Potassium Chloride	potassium supplement	No effects on voice or speech mechanisms have been reported.
Pravachol	B-M Squibb	Pravastatin	antihyperlipidemic	No effects on voice or speech mechanisms have been reported.
Prednisone	various	Prednisone	antiinflammatory/ steroid	Prednisone's effect is beneficial when used to shrink swollen vocal tissues, although patients taking it must be carefully monitored by a physician. It is not advised for patients with vocal fold ulcers, hemorrhages, or acute laryngitis.
Premarin	Wyeth-Ayerst	Conjugated Estrogens	hormone - estrogen	No effects on voice or speech mechanisms have been reported.
Prempro	Wyeth-Ayerst	Conj. Estrogens/ Medroxyprogesterone	hormone - estrogen/progestin	No effects on voice or speech mechanisms have been reported.
Prevacid	Tap Pharm	Lansoprazole	gastrointestinal - antisecretory	These agents have a favorable effect on the voice in that they reduce esophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Prilosec	Astra	Omeprazole	gastrointestinal - antisecretory
Prinivil	Merck	Lisinopril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Procardia XL	Pfizer	Nifedipine	cardiovascular - calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Promethazine tabs	various	Promethazine	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 prone to injuries, such as nodules.
Propacet 100	Teva Pharm	Propoxyphene N/APAP	narcotic analgesic	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.
Propoxyphene N/APAP	various	Propoxyphene N/APAP	narcotic analgesic
Propranolol LA	various	Propranolol LA	cardiovascular - beta blocker	No effects on voice or speech mechanisms have been reported.
Propulsid	Janssen	Cisapride	gastrointestinal stimulant	No effects on voice or speech mechanisms have been reported.
Provera	Pharmacia/ Upjohn	Medroxy progesterone	hormone - progestin	No effects on voice or speech mechanisms have been reported.
Prozac	Lilly	Fluoxetine	antidepressant	Prozac 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 be more prone to injuries such as nodules.
Ranitidine	various	Ranitidine	gastrointestinal H2 antihistamine	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 gastro-esophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Relafen	SmithKline Beecham	Nabumetone	nonsteroidal anti-inflammatory	Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Retin-A	Ortho Derm	Tretinoin	topical acne agent	No effects on voice or speech mechanisms have been reported.
Rezulin	Parke-Davis	Troglitazone	antidiabetic	No effects on voice or speech mechanisms have been reported.
Rhinocort	Astra	Budesonide	steroid nasal spray	Throat irritation and dryness, cough, hoarseness and voice changes are all possible adverse reactions. Rarely, oral or nasal candidiasis may occur.
Risperdal	Janssen	Risperidone	antipsychotic	Risperdal may have adverse effects on speech, including difficulty in articulating words.
Roxicet	Roxane	Oxycodone/APAP	narcotic analgesic	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.
Serevent	Glaxo Wellcome	Salmeterol	antiasthmatic/ bronchodilator	Inhaled bronchodilators sometimes dry or irritate tissues in the mouth and throat and may lead to hoareseness, soreness, voice changes or laryngititis. Dry vocal tissues may be more prone to injuries, such as nodules, as well.
Serzone	Bristol-Myers Squibb	Nefazodone	antidepressant	No effects on voice or speech mechanisms have been reported.
Singulair	Schein	Montelukast	antiasthmatic maintenance	No effects on voice or speech mechanisms have been reported.
Sumycin	Apothecon	Tetracycline HCL	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Synthroid	Knoll	Levothyroxine	hormone - thyroid	No effects on voice or speech mechanisms have been reported.
Tamoxifen	various	Tamoxifen	antineoplastic/ antiestrogen	No effects on voice or speech mechanisms have been reported.
Temazepam	various	Temazepam	hypnotic/ benzodiazepine	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.
Tiazac	Forest	Diltiazem	cardiovascular-calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Timoptic XE	Merck	Timolol	antiglaucoma agent	No effects on voice or speech mechanisms have been reported.
Tobradex	Alcon Lab	Tobramycin/ Dexamethasone	ophthalmic antibiotic drop	No effects on voice or speech mechanisms have been reported.
Toprol-XL	Astra	Metoprolol	cardiovascular - beta blocker	No effects on voice or speech mechanisms have been reported.
Trazodone	Sidmak	Trazodone	antidepressant	No effects on voice or speech mechanisms have been reported.
Tri-Levlen	Berlex	L-Norgestrel/ Ethinyl Estradiol	hormone - oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Triamterene/ HCTZ	various	Triamterene/ HCTZ	diuretic combination	Diuretics have a drying effect on mucous membranes, including those used for 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.
Trimethoprim/ Sulfa	various	Trimeth/Sulfameth	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Trimox	Apothecon	Amoxicillin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush..
Triphasil	Wyeth-Ayerst	L-Norgestrel/ Ethinyl Estradiol	hormone oral contraceptive	The use of oral contraceptives has not been shown to significantly affect female voices.
Ultram	McNeil	Tramadol	analgesic	No effects on voice or speech mechanisms have been reported.
Vancenase AQ DS	Schering	Beclomethasone	nasal decongestant	Sore throat, cough, and rarely, perforation of the nasal septum, are possible adverse effects.
Vasotec	Merck	Enalapril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Veetids	Apothecon	Penicillin VK	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Verapamil SR	various	Verapamil	cardiovascular - calcium channel blocker	No effects on voice or speech mechanisms have been reported.
Viagra	Pfizer	Sildenafil Citrate	peripheral vasodilator	No effects on voice or speech mechanisms have been reported.
Vioxx	Merck	Rofecoxib	nonsteroidal anti-inflammatory	Infrequently, this agent may cause acid reflux or cough, both of which may lead to vocal tissue damage.
Warfarin	Barr	Warfarin	anticoagulant	Vocal performers, particularly, should be cautious about using medications that decrease platelet function during periods of strenous voicing demands, due to an increased possibility of vocal fold hemorrhage.
Wellbutrin SR	Glaxo Wellcome	Bupropion HCL	antidepressant	No effects on voice or speech mechanisms have been reported.
Xalatan	Pharmacia/ Upjohn	Latanoprost	antiglaucoma agent	No effects on voice or speech mechanisms have been reported.
Xanax	Pharmacia/ Upjohn	Alprazolam	antianxiety/ benzodiazepine	Less than 1% of patients who take benzodiazepines experience slurred speech and symptoms of dysarthria (slow, uncoordinated speech).
Zantac	Glaxo Wellcome	Ranitidine	gastrointestinal H2 antihistamine	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 gastro-esophageal reflux. Uncontrolled spillage of stomach acids into the larynx is harmful to delicate vocal fold tissues.
Zestoretic	Zeneca	Lisinopril/HCTZ	cardiovascular - antihypertensive	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 or laryngitis are possible symptoms. In addition to irritation effects, dry vocal folds may be more prone to injuries, such as nodules.
Zestril	Zeneca	Lisinopril	cardiovascular - ACE inhibitor	Excessive coughing has been associated with the use of ACE inhibitors, which in turn, may lead to hoarseness and possible vocal tissue damage.
Ziac	Wyeth- Ayerest	Bisoprolol/HCTZ	cardiovascular - antihypertensive	Diuretics have a drying effect on mucous membranes, including those used for 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.
Zithromax and Zithromax Susp	Pfizer	Azithromycin	antibiotic	In general, no effects on voice or speech mechanisms are associated with antibiotic use. It should be noted, however, that antibiotic abuse can lead to an overgrowth of candida in the body, possibly leading to laryngeal thrush.
Zocor	Merck	Simvastatin	antihyperlipidemic	No effects on voice or speech mechanisms have been reported.
Zoloft	Pfizer	Sertraline	antidepressant	Zoloft 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 be more prone to injuries such as nodules.
Zyban	Glaxo Wellcome	Bupropion HCL SR	antidepressant	No effects on voice or speech mechanisms have been reported.
Zyprexa	Lilly	Olanzapine	psychotropic agent	Infrequent effects may include coughing, pharyngitis, or (non-defined) voice alteration.
Zyrtec	Pfizer	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 prone to injuries, such as nodules.

Notes on preparation of this document: The original table (posted in June 1999) listed the 200 most-frequently prescribed medications in the U.S. in the year 1998. Information for 1999 prescribed medication usage is now available, and thus, 18 more medications have been added to the table. The FDA prohibited distribution of several prescription medications recently, and these medications have been deleted from the table. A registered pharmacist prepared the document, using the following sources: American Druggist - 1996; February 1999 PP 42-43. The top 200 most-frequently prescribed medications in the U.S. in 1999, Rxlist.com; Micromedex, Inc., Vol 95, 1974-1998; and package inserts.