Methotrexate and alcohol?

[Nildesperandum]

Hi. I am recently diagnosed, just started steroids which are great and made me feel almost human ! Will start methotrexate Sunday. Consultant said no more than 10 units of alcohol per week, but the leaflets say no more than 4 units. Hmmm!? Can anyone give me a better idea as there is a big difference between the two!! Thanks. Sally x

[helixhelix]

It's not an exact science, as lots of variation between consultants and between people. Certainly no more than recommended max weekly limit, and no binge drinking ie using up whole weekly allowance on Sat night, but beneath that people have been told many different things and different people have different tolerances to the alcohol-MTX mix. I'm no doctor, but my advice would be to steer completely clear of alcohol for the first few weeks to give your body (and especially liver) the best chance possible to get accustomed. After that start very gradually to see what suits you, as blood tests will soon tell if the mix is a no-no for you. And you may find like me that you have just gone off alcohol. I used to drink loads, but now hardly drink at all, as my priority is to be as well as possible and look after my liver, but I do have maybe one unit a week and maybe 2 or 3 on special occasions. And it doesn't bother me now -took a while to get used to, but you adapt quickly! Polly

[Nildesperandum in reply to helixhelix]

Thanks Polly! Yes I hadn't really thought through the fact that I would be able to see what my liver makes of it all on a regular basis. I do like a nice glass of wine but find it difficult to stick at the one glass once I have started. Looks like I will have to find my 'off'" switch! Grrr. Oh well !

[Ronnie63]

Hi Sally

I was also told 10 units but not all at the same time 10 units is roughly a bottle of wine. I have defintiely had elevated ALT levels when I've either drunk >10 units over a week or >10 on one night (which I now never do).My rheummy told me as long as ALT <70 it is ok and <100 is tolerable for a short period. I try and keep mine around <50 but everyone tolerates it differently. I was gutted when I learnt I had to restrict alcohol as it does help you relax and we all need a vice (within reason!!) Moderation is a difficult thing to come to terms with when you're trying to accept the disease as well but I've come to the conclusion that's it's better to give the drugs a fighting chance even if it means deprivation

Good luck x

[Nildesperandum in reply to Ronnie63]

Hi. Yes I am a bit gutted but time to grow up and get on with it and try not to sulk!

[Shell1967]

Hi im on mtx too,for the 1 st 3 mths I stayed tee total to give mtx the best possible chance,and after that time I introduced alcohol slowly.i was told upto 10 units per week but not all on one night.i have been fine apart from once but it was my birthday night out :)) now I just stick to around 5 units a week.good luck Michelle xx

[Nildesperandum in reply to Shell1967]

It's great that you are all giving the same advice, to stay off it for a while and then reintroduce slowly. So that's what I will do. Thanks Michelle x

[Hidden]

I Advise just the occasional glass of wine when handing out MTX to patients.. had one today.. it is used for skin conditions as well as RA..

[Nildesperandum in reply to Hidden]

Thanks! Ho hum. Never mind!

[claireyj]

Hi agree don't drink anything for at least a couple of weeks :(( let the methx settle after that see how you go ...but like you after a day at work , kids etc etc I love a glass of wine ...Im on 20mg mtx injections and just started sulphasalazine ... love my wine but drink it as a spritzer and stick to a bottle about 11 - 11.5 % have a few at the weekends and none in the week and my liver results been fine ...you got to live eh everything in moderation.. My friend Michelle and myself were so confused with so many mixed messages when first diagnosed , listen to your consultant and keep up with regular blood tests..Love Claire xx

[Nildesperandum in reply to claireyj]

Thanks Claire. Abstemious few weeks for me then x

[Hidden]

I agree with everyone - stay off it for a while until your first few blood tests are clear and then slowly introduce a bit and see what the next blood tests bring. I emphasise caution because in my 18 months on oral and then injectable MTX I've had four dodgy liver readings. The first one came back pretty high and I had to drop back down a few doses which, considering I was still flaring away badly was more than a tad frustrating. This was down to a hike in dose from 7.5 to 15mgs without any stepping up slowly to the doses in between I think. But I did have a small glass of whisky at hogmanay when I had a really heavy cold and we had visitors so it might have been that too. After that I found that if I had anything at all to drink - even just a few units - my liver would tell tales on me and I'd have to have more frequent blood tests for a while until it settled back down. Now I seem to be able to get away with more wine and the odd g&t and liver is only sitting at the high end of the normal range. My liver is obviously a bit sensitive but basically alcohol can increase the toxicity of the MTX. What a pain eh?!

[Nildesperandum in reply to Hidden]

Total pain. And it's so hard when you are with friends and everyone is enjoying a glass. People look at you as if you have two heads when you say you aren't drinking don't they!! Need to develop a thicker skin and a strong will!,

[Hidden]

You need to start out with one certainly - but hopefully you will be able to relax more once your bloods start showing up fine. X

[Lukaduka]

Hi, I too have just been diagnosed with RA and had a depomedrone injection 4 weeks ago. Just started methatrexate (2nd dose last night). I am so pleased I am not the only person asking this question! My consultant must have thought I had a drink problem when all my questions I asked before starting MTX involved alcohol! It is a big change for me I don't drink in the week normally but would drink between 8-14 units at the weekend. I loved the previous comment about grow up and get on with it as that is how I am trying to view it! Who needs alcohol to have a good time - it will just take a bit of adjusting. I have bought a selection of no or low alcohol drinks. Some are awful - especially alcohol free wine, but Bavaria beer is quite good and some of the 5.5% wines (ban rock lighter) are not too bad and at least if you are going to friends or a party you can take your own and not feel completely left out. After my first dose I didn't fancy it much but had 1 carling zest which is only 0.7 units (2 days later) and tonight I had 2 units and did not seem to mind stopping which is odd for me. My consultant said to always avoid having alcohol on the same day as MTX, and limit to 5 units. I wish you all the best, fingers crossed you have no side effects, I have only felt thirsty and I can cope with that. This site is excellent by the way now feel less alone! Sx

[Nildesperandum in reply to Lukaduka]

You sound similar to me. I hardly drink at all during the week but do like to at the weekends. Need to man up and get real don't we! Maybe I will find that I don't fancy it as much like you!! Determinedly sank a whole bottle this evening as my swansong! First dose mtx on sun so will lay off it now! It's all a bit life changing isnt it!!

[jeanabelle in reply to Nildesperandum]

I know the feeling......my x partner and I belonged to a bike club ( the touring, cruising type). In the summer we traveled everywhere all over Europe and had a really great time. We would camp out and has some great sessions, we were all Irish and you know how we Irish love to party, sing etc etc. I'd like to say too that despite the stereotype there was never a raised voice (except in laughter) never mind a fight!!!

When I was first diagnosed I was put on MTX and it was great, life was wonderful again. Then my bloods started to show signs of my liver struggling to keep up so I was told no drink at all. I have to say when it came to a choice of a pint of cider or no pain I made the right choice and stayed on the MTX. Unfortunately I was unable to stay on it and eventually went on to biologicals. That was three years ago and I have hardly had a drink since. I do have the odd Irish Mist over ice of an evening but that's about it.

I hope it works out for you anyhow and remember we are all different and this disease is never the same for two people. All the best. Jean. X

[Hidden]

I have no problem having a drink when taking methotrexate however I never drink on methotrexate day or for three days after, so I just have a drink at weekend

However everyone is totally different I have a friend who drinks a good few pints with hers and another who can't tolerate any alcohol without her liver blood results going through the roof

It's trial and error but be carful and I would see how you go on with taking methotrexate first before worrying about alcohol.

[mille in reply to Hidden]

I was clearing out yesterday and came across an old leaflet from 12 years ago and it said no more than 7 units a week. If we have been out for a night i will admit to going over the limit but it is not very often.

[Hidden in reply to mille]

My GP and rheumatologist didn't give me a limit but I did avoid alcohol completely until I knew how my bloods were etc

[Neonkitty]

On starting MTX ten years ago my rheumy said not more than two units a week. I never have done and got used to alcohol only on special occasions. I think ten seems rather a lot? Maybe things have changed over the years?

[Nildesperandum in reply to Neonkitty]

Yes it does seem a lot in comparison. Have decided to just stay off it x

[Neonkitty]

I think if blood results are good and constant, then a couple of weekend drinks are allowed. I occasionally have a Crabbies Black alcoholic ginger on a Saturday (hardly sinful ... It is lovely though!) and a glass of fizz at parties etc but anything else I don't really. Just got used to it. Good luck with the MTX. Once established, as Tilda says, you can see if having one or two more affects you.

Julie x

[Krystle1us]

I have been on Methotrexate for about 3 months. I do ok. I have some side effects. I drink a little here and there. But Friday evening I blacked out. I didn't even have that much to drink. But a complete black out and apparently flipped out. This has never in all my life happened. Has anyone had this happen to them while drinking

[Grayling]

I can't believe the difference of alcohol amounts we are told we can drink, I was told when on MTX to drink nil alcohol, its hard when you are used to a pint, but it's better to have a healthy liver, we all go through enough without adding liver failure to the list, I drink Fanta lemon on holiday, the look on the waiters face when I gave my wife the pint glass and me on the lemon! it's not bad mind over matter. Cheers