The aetiology of acute tinnitus is mostly idiopathic like sudden sensorineural hearing loss or caused by noise and rarely infectious or vascular. Therefore there is currently no causal and effective drug therapy available. Although there is a low level of evidence, treatment with glucocorticoids and initially plasma expanding infusions (HES) is recommended for acute tinnitus if there is no spontaneous remission. Intratympanic glucocorticoid therapy can be used as an alternative if there is severe hearing loss together with tinnitus. In chronic tinnitus there is really no indication for pharmacotherapy. Sometimes