hi
wondering if anyone can help ?
recently been diagnosed with rumatoid arthritis and been on methotrexate for 3 weeks now
advice is to drink in moderation so far i haven't drunk at all however its coming up to Christmas and I have lots of events planned that will involve alcohol im not a big drinker but when these come around i dont want to constantly be calculating what I drink
will it do much harm if i went over the recommended limits!
thanks so much for any help x
The problem is that you haven’t been on MTX long enough to know how it affects your liver.
I’ve been on it around 9 years and I didn't drink at all to start with and then slowly added in a bit of alcohol and if my blood tests were fine then that was ok. Now I drink the recommended amount without it seeming to affect my liver, and will probably go a bit over at christmas. But my rheumatologist advises me not to overdo it, and absolutely not to binge drink so 3 small drinks is my absolute limit.!
In your position I think I would be cautious and stick to the recommended limits. You learn to like spritzers with RA!
Here’s the NRAS guidance
I totally agree with Helix Helix.
I have been taking Methotrexate 15mg since September this year. My blood tests are all perfect thank goodness. I have not drank Alcohol since then. I do believe that my body has maybe taken to it so well because I’m not giving my liver anything else toxic.
I would love to have a few Christmas as people do overdo the drink and food at this exciting festive time. But most people are not on this drug, and I am just not willing to risk how much better I have felt since taking Methotrexate.
I do not ever want to go back to the flares RA gave me EVER!
Hiya cpr02, welcome, though sorry you’ve been diagnosed. Your first question is unfortunately one only your Rheumy can answer, even then he may not be able to give you a definite answer you being so new to MTX. The biggie is how your liver takes to it & that can only be known once you’ve been on it longer & had more drug monitoring blood tests . If you hold your own records what you'd be looking for is the values of your AST/ALT & ALK PHOS, how they differ from normal values (my lab work on 7-40 IU/L & 30-125 IU/L, yours may be slightly different). You don't say what dose you're prescribed either but the higher the dose the more effect on the liver it can have potentially. Also binge drinking is discouraged, which makes sense.
I don't wish to seem a Debbie Downer but I’d abstain, you're only at the start of treatment & most meds are filtered through the liver, something else to think about if you're being prescribed anything else, it may not be just MTX you've to consider.
There are plenty of very good alcohol-free alternatives pretty much across the board if you're able to have a good time without the effect of alcohol. I don't drink & it's quite honestly nothing I miss, even the odd glass I could have before choosing to not drink & I’m on plenty of meds, MTX for over 10 years. It can be quite eye opening actually seeing what people do with a drink or two inside them & you're compos mentis! It would also save you a packet in taxi fares over Christmas when they rank up the charges. Were you much of a drinker before? Not wanting to pry & I don't want to know but it's something to consider, how hard your liver worked pre RD. It is a remarkable organ in that it's able to repair itself but there's a limit to how much it can regenerate.
Anyway, it's entirely your choice, just giving my experience, but I really would ask what your Rheumy thinks. I take it the advice you mention is what you've read, if so it really is on a case by case basis so what can be considered moderation for one may not be for another when on MTX especially.
Sorry if it's not what you'd hoped to hear but RD is something that will insist on being listened to, including how it can affect our internal organs, that's without adding the meds into the mix. Of course it doesn’t mean that you won't be able to drink ever again just that prudence is needed just now. It's unfortunate you’ve been diagnosed & started treatment this time of year. If you really do feel you need a drink to celebrate then I’d suggest you don't drink the day you take MTX, that's really not a good day to give your liver the need to work extra.😕
I don’t drink often but when I do go out I like a drop or 2 😁. You don’t know how your meds effects you liver yet but my liver does play up when I drink. I take my methotrexate on a Wednesday so I’m clean either side of the weekend. I drink lots of water after and eat liver cleansing food for a good few days. For me I love a drink when socialising and life is miserable enough not to have fun now and then but an RA hangover ( joints really play up plus fatigue) is worth it sometimes 😁😁 but this is me every one is different
Hi what are liver cleansing foods?
You can google them.... lots of greens, fibre (I use a powder from a health shop you mix with water)beetroot is very good I use a concentrated shot🤮but it works for me. Ginger tea and warm water with lemon juice and lots of water
Fab advice x
It’s up to you of course...but Alcohol with Mtx can really mess things up...especially as you have only been on it for 3 weeks & have been off the booze .
Once you are settled on Mtx try it then..... But Christmas parties are not really the place to start experimenting are they?
To cheer you up I took Mtx for seven years and drank wine most evenings but I did lay off until I had been on it safely for three months before went back to wine.
In May, I had a flute of champagne at an evening social gathering, then took my 8 tablets of methotrexate the following morning. A few hours later, I was throwing up and felt so exhausted that I could do nothing but lie down for the rest of the day. While the champagne did not have a bad effect on my labs, I felt so terrible that I will never do that again. I recently had 2 mimosas at a brunch (just a splash of champagne in the glass) and was fine. Otherwise, I stick to water, carrot juice, concord grape juice, and green tea. Normally, I feel slightly fatigued for a few hours after taking the methotrexate, but I can still go to the gym, go to work, walk up stairs rather than taking the elevator, etc.
Hi, if you're a wine, beer or lager drinker you can get some fairly decent low or no alcohol ones these days. I'm not on methotrexate now but when I was I kept off alcohol for the first 3 months. After that I gradually reintroduced wine. I drank more than usual around my birthday and my ALT shot up which scared me! it was back to normal at next blood test though.
There is a lot of conflicting opinions about this. The best studies are out of Europe and appear to suggest that mild to moderate drinking is just fine. I have been on methotrexate for 18 months now, 20mg, and I drink on the weekends. I take my injection on Tuesdays. The best advice I have is to monitor your liver on a regular basis. At times mine creeps up slightly higher, and that is a check for me to be more in moderation for a few weeks. Slightly higher is still well within normal limits. have been on methotrexate for 18 months now.
I have never been a heavy drinker, I have only ever had one hangover!
When I started on MTX I went teetotal for about 6 months and then introduced a small amount of alcohol gradually. Now I drink less than 10 units per week. My blood test results have been fine. The warning is however we all different and our bodies react differently to MTX.
This Christmas you should be cautious as you have not been on MTX very long. As others said you can enjoy yourself fine without alcohol. Make sure that you don't binge, have alcohol free days, preferably several together.
I took a sudden dislike to alcohol in the run up to becoming unwell with RD 3 years ago. I haven't touched it since. For me it's not worth upsetting my treatment for. I was a bit of a wine buff 'till then.
I now have tonic water, dressed up with lemon, lime , ice, mint and enjoy it. It looks like an adult drink, a G and T perhaps and stops the incessant questions ' are you not drinking' ?
Each to their own, but do take care and best to stick within the guidelines.
Apart from the live,r the consequences of drinking alcohol and taking MTX, you will get drunk much, much quicker than if you are not on MTX. Take Care.
Is that right Recorder? I've not heard that before.
Yes, one minute you are not drunk, the next you are and their alcohol intake was really quite low. Take Care.
Hi cpr, Its Simple, don't drink while on MTX, you have enough problems with RA without adding to them, you can live with RA, but not with a pickled liver. Its not all that bad having to say no, and don't forget the booze will show up in your blood tests. Have a good Christmas.
Personally I have quit drinking since starting methotrexate and I did always love a bottle of wine at weekends. However over the summer I had a odd glass here and there but it did leave me feeling very fatigued. I don't miss alcohol now these days at all, it's just not worth the hassle. Have a chat with your rheumatologist and see what they advise.
Mixing both can cause even worse liver problems. Being on the methotrexate is bad enough on the liver!
I personally would not mix the two, even during holidays. Why make your liver scream more than it already has to?
Not worth the risk. We RA sufferers are already being slowly poisoned with all the RA medications. Adding alcohol to the mix?
Over the years I’ve been taking mtx the guidelines about alcohol have changed a few times. At the start I was told definitely not to drink at all, then that changed to the occasional drink and then not to excess or bingeing. As others have said, I just don’t want to risk being the person who is unlucky and has liver problems because of mtx and alcohol, So I choose to rarely drink. Having said that I’m such a lightweight now that I usually don’t bother as it really goes straight to my head. Of course it’s entirely up to you what you decide to do, I hope you have found the comments useful in making that decision. 🍻
My rheumatologist was adamant that I avoided alcohol. She said that if I wanted to continue drinking alcohol then she wouldn’t prescribe methotrexate. I can take or leave alcohol to be honest, and my liver already has its work cut out processing the methotrexate, so I avoid alcohol. My liver function tests have been fine.
I follow no alcohol for 72 hours after my dose of methotrexate and then moderation until abstain again 24 hours before my dose.
It works well for me.
These days there is much less stigma attached to not drinking, and more alternatives to alcohol than ever before - your nearest large supermarket will carry a good range (not Aldi yet😣). And having a drink isn't so relaxing if you're constantly wondering if it's knackering your liver....
Happy and pain-free Christmas everybody x
No, I'm surprised at Aldi being behind the door not selling any alcohol-free. Lidl do an acceptable alcohol free lager, Perlenbacher 0.0%, 6 pack in bottles.
I have been on methotrexate for 12 years and other than a few pints of beer and a few shorts spread over that period I don't drink at all. There are plenty of alcohol alternatives you can take over the festive period, and still enjoy yourself, without feeling an outsider to the rest of the crowd.
Hi, I've been on MTX 15mg for a couple of years now and have drunk a very limited amount of alcohol during this time without any ill effect. I tend to stick to weekends only so I have several days clear and max 10 units a week (but usually a lot less, e.g. 5, which equates to a couple of drinks). I think you will just have to try it and see. I usually don't drink a day either side of my MTX, just to give my liver a fighting chance. Good luck!
Hi have been on methotrexate for 13 years and various biologicals and have never given up alcohol altogether, have never been a heavy drinker but I do like a drink to celebrate Birthdays and Christmas and whilst on holiday, my metho dose has varied from 10 mg to 25 mg my present does is 20mg . My max alcohol intake would be 2.5 units. My blood readings have all been within the guide lines.
Merry Christmas
I hope the info helps
Do you still drink alcohol whilst on methotrexate?
Alcohol and RA at Christmas 
Dmards, alcohol and depression!
Methotrexate
