Check this out...moderate drinking whilst taking Meth... - NRAS
Check this out...moderate drinking whilst taking Methotrexate does not risk liver
My Rheumy told me this as soon as I went on MTX. Moderation his Moto was. No binging. Liver is tested every month in your bloods as well. Tea total now tho any way... good news for those who like a tipple or two
Interesting article. However, the "Sticking to modest levels of drinking 'likely to be safe' bit still rings alarm bells for me?
That's what my rheumy nurse told me too. I've never been a heavy drinker so going up to 14 units a week would possibly be OK but I'd still be on the floor
I've been drinking lightly since I've been in methotrexate - about 2/3 glasses of wine a week. The only thing I find that it affects me very quickly. My rheumy said that it's ok to drink, but in moderation as having one drink is the equivalent to having two normally. So just be sensible. Good advice, I thought. Liver results have always been fine.
My rheumatologist told me drinking the odd glass of wine would be fine when I went on mtx in August. Drinking anymore than one or two a week would be impossible for me as it makes me feel ill. Lol. Liver results all fine. X
I rarely drink, but had a glass of Prosecco then a glass of wine with a meal as a birthday treat - ended up with a deranged liver. ALT of 958! My rheumy thought it was hep A but tests came back negative. I suspect it was the combination of sugar, fat and alcohol in higher amounts than I usually have, combined with the methotrexate. Yes, moderation is best. For me I am off methotrexate for now and the liver has recovered ALT 13 last count.
Just be careful.
Yeah Alderess - Some folks are just more sensitive to MTX than other folks are...
Alderess... you never had liver issues before the drinking on Methotrexate? My liver is fine on Methotrexate, though I haven't tried drinking yet. I was thinking about having one or two drinks now and then, but am a bit nervous. I guess I'm just wondering if your liver results were also great on Methotrexate before an attempt at drinking. Thanks.
Hi Needforname - I would suggest that maybe you have a drink or two the day or so before you go for your next bloods and then compare to your previous ones. That should tell you a little. Also, if you are nervous about it, then just don't have a drink. It probably isn't worth the fear and insecurity..
Thanks for the suggestion. That's what I was thinking. Regarding the nervousness, I just obviously wouldn't want to damage my liver. I wouldn't quite go as far as to say I'd be fearful or insecure about it. Just trying to find the fine line between living life and making smart decisions.
Absolutely! Smart Choice
Needforname - I have been on Methotrexate for 14 years. I have tended to drink a couple of glasses of wine with a meal occasionally, but I don't drink regularly. I found my ALT results would rise a bit (go from my usual 14 to 24/26,) then it would go back down by the next monthly result. My rheumy rang me when it went to 56, and I could see that I had drunk more than usual the night before the blood test.
My deranged liver was a one off, I think. It was combined with severe upper right abdominal pain. It happened a week after a Rituximab infusion and 2 days after methotrexate @ 20mg. From my perspective the thing that tipped my liver into misbehaving was most likely the combination of methotrexate and much more alcohol than usual plus overeating rich food. It was a most wonderful meal, but I shall try be so indulgent again. I paid a high price for a special birthday.....I am no longer on methotrexate, but I would happily go back on it if needs be in future. It certainly helped the RA.
As others rightly say. We're all individual and we need to be aware of the potential for difficulties with any drugs. Methotrexate is known to be potentially bad for our liver if combined with alcohol. Moderation and observation of how you feel are the key. Have a drink and see how you feel, but listen to your own body.
All good wishes. Let's hope a cure is available soon, then we can forget about all these worries about drugs! X
Good advice. It's good you can see a correlation with the drinking and the blood testing. Hopefully the MTX will eventually start working for me, so I can justify taking this stuff. I'm assuming you're in remission since you stopped. If so, congrats!
This troubles me a little because it's all so individual & this comes across as general info, that we can all drink within limits & be fine, maybe even our Rheumy could recommend this when initially prescribing before any drug monitoring blood tests are taken.
From experience many people don't know for certain what the units of alcohol are, the ones specific to their choice of drink & are surprised when they're explained to them. This often means they weren't aware just how much over the NHS recommendations they're drinking or that the ABV% in not only beers but wine can make a considerable difference to units 'allowance'. "Likely to be safe" doesn't mean safe but to those who do really like a tipple it probably won't figure....by that I mean those who would be drinking more than modestly if they weren't prescribed MTX or saving their allowance for the weekend & possibly drinking more than they intend.
Also, I'm not alone in taking daily meds that can also have an affect on the liver, other than weekly MTX, this isn't taken into account. Then there are oddities like me who don't drink for whatever reason, mine being not tolerating alcohol, yet my liver can be fine on one dose of MTX but increase it by as little as 2.5mg & my LFT rises enough beyond normal value to be of concern.
I'd prefer if it had an addendum saying something along the lines of depending on your liver results generally or if they're always on the low side of values. Or, it's recommended alcohol is avoided the day before & until the day after MTX is administered.
What troubles me about saying it is fine to drink in moderation is that alcohol, particularly flat wine, is very very addictive and it affects the brain.
Thus, when you have had your moderate drink allowance, you are not fully rational and many people will just reach out for the bottle and finish it, and then possibly open another.
There is not such a craving effect after drinking spirits or beer.
Smoking is quite different. Whilst it is addictive, it does not affect the brain (there is no driving ban on smoking), and you are still fully in control.
Quite frankly, it is as bad as heroin.
Interesting! I presume that having a drink is as personal as the disease in terms of your individual blood work and liver results. But I know when I was on MTX, I could have a few drinks on the weekend without affecting anything negatively...
If you don't mind me adding the NHS recommended units cag1 I'll list them below, it might be helpful in giving approximations in regard to the link you provided. Both men & women are advised not to drink more than 14 units a week & if you do it's also advised you do so over 3 or more days, particularly if you regularly drink as much as 14 units a week. These are guidelines for 'normal' people of course!
Wine - 1 x 125ml glass (traditional small pub measure) 11% ABV 1.4 units or 14% ABV 1.8 units
Wine - 1 x 175ml glass (standard pub measure) 11% ABV 1.9 units or 14% ABV 2.4 units
Wine - 1 x 250ml glass (large measure or 1/3rd of a bottle) 11% ABV 2.8 units or 14% ABV 3.5 units
Wine - 1 bottle, 175ml 11% ABV 8.2 units or 14% ABV 10.5 units
Lager, Beer or Cider - 1 x half pint (284ml) 3.8% ABV 1.1 units or 5.2% ABV 1.5 units
Lager, Beer or Cider - 1 x can (440ml) 3.8% ABV 1.7 units or 5.2% ABV 2.3 units
Lager, Beer or Cider - 1 x pint (568ml) 3.8% ABV 2.2 units or 5.2% ABV 3 units
Lager, Beer or Cider - 1 x bottle (660ml) 3.8% ABV 2.5 units or 5.2% ABV 3.4 units
Spirits - 1 x 25ml (small pub measure) 40% ABV 1 unit
Spirits - 1 x 35ml (large pub measure) 40% ABV 1.4 units
Alcopop - 1 x bottle (275ml) 5.5% ABV 1.5 units
1 x 50ml glass Vermouth eg Cinzano 15% ABV 0.8 unit
1 x 50ml glass Cream Liqueur eg Baileys, Sherry 17% ABV 0.9 unit
1 x 50ml glass Port or Liqueurs eg Tia Maria 20% ABV 1 unit
1 x 50ml glass Dessert wines or Liqueurs eg Pimms, Campari 25% ABV 2 units
1 x 50ml glass Liqueurs eg Orange Curacao, Limoncello 30% ABV 1.5 units
Good info there🤔
My rheumatologist told me drinking in moderation is fine, and I do. Only red wine as white wine makes my joints flare, but I certainly can't drink as much now as it does affect me more. Probably a bottle or so a week, maybe more and My bloods are always ok.
Oh happy days. Don't drink on injection day but have a glass of wine on the others! LFT been OK up to now (about 8 years) but good to have it medically recognized.
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