Problem Human case reports have been published demonstrating a rapidly progressive sensorineural hearing loss associated with overuse or abuse of acetaminophen/hydrocodone. We hypothesized that hearing loss would result in the guinea pig model if given high, chronic doses of this drug. Methods Sixty female, pigmented guinea pigs were randomly assigned to a control, acetaminophen, hydrocodone, or acetaminophen/hydrocodone group. All guinea pigs were tested with baseline ABRs on day 0, and post drug/placebo administration on days 30, 60, 90, and 120. At the end of the study 5 animals from each group were sacrificed and their cochleae were harvested for histological investigation. Results No significant change in threshold (dB) was seen between the 4 groups. Histological studies of the cochleae revealed no hair cell damage in any of the groups. Conclusion Hydrocodone and acetaminophen/hydrocodone do not have an obvious deleterious effect on guinea pig cochlear function or structure. Significance This study may indicate that human hearing loss seen with abuse of acetaminophen/hydrocodone is multi-factorial and not just related to the drug abuse alone.