Do you still drink alcohol whilst on methotrexate? - NRAS

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Do you still drink alcohol whilst on methotrexate?

Langers2 profile image
18 Replies

If methotrexate is damaging for the liver how much do you drink?

Im trying to be good and only drinking on special occasions since being diagnosed but temptation is getting the better of me. Before being diagnosed I could hardly socialize (in the evenings especially) because I was constantlyin pain. Now that my RA seems to be undercontrol, I want my old life back. I want to go out in the evenings and enjoy drinking with my friends.

Bad idea?

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Langers2 profile image
Langers2
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18 Replies
skinnycappuccino profile image
skinnycappuccino

Hello Langers2,

Of course it would be better to ask your rheumy as the advice re booze seems to differ but my rheumy says having the odd drink whilst on RA meds is not a problem. It would probably be a bad idea to drink regularly though. When my liver enzymes were a little elevated last December, I stopped drinking altogether, they're back to normal now but I have no idea if it was actually the booze that was responsible - might just as well have been the meds I was on then!

I think it also depends if you're on any other meds apart from MTX, i.e. drinking is not recommended whilst taking NSAIDs as far as I am aware.

All the best,

Christine xx

runningbracken profile image
runningbracken

I stopped drinking when started Mtx. Its advised not to drink but i know my cousin who also has RA enjoy's a couple of glasses most weeks.

AgedCrone profile image
AgedCrone

If you want the truth……yes bad idea!If you speak to your rheumy he/she will explain how drinking alcohol regularly whilst taking Mtx can affect your liver …hence your general health…..so you would probably not enjoy drinking anyway.Some people are able to drink in moderation on Mtx……but I don’t think that means going out in the. evenings just to drink.

So sorry…yes it is a bad idea, unless you can stick to a limit your doctor may think possible.

Langers2 profile image
Langers2

Thanks all. I thought as much 😔 but just needed to hear it from someone else.

Life changing adjustments are necessary. Still getting my head round it. Need to keep reminding myself that I should be grateful I'm not in constant pain anymore. Can't have it all 🙄

AgedCrone profile image
AgedCrone in reply toLangers2

It’s not all doom and gloom once you’ve been on methotrexate for a while and your doctor can see how your RA & your liver reacts you might be able to have a few drinks.Who knows …..stay off it for a few months ….you might lose the taste for it?

I do like a drink but not as often as I use to or as much . As my rheumatologist said it’s about balance and of course you gotta live a little. I didn’t drink at first I wanted to see how MTX effected me . I don’t deny myself if I’m socialising . We are all different

Mmrr profile image
Mmrr

I developed a dislike for alcohol as one of my early symptoms of RD, and have never taken any since. Others on the forum enjoy a glass of wine without adverse effects, but take care not to put your liver under too much pressure 🍷

nomoreheels profile image
nomoreheels

Hiya Langers2, welcome. I don't drink alcohol because it just doesn't like me. I can manage a half can of Guinness & black though! Honestly, it’s all down to how healthy your liver is, not only because of MTX but any meds you take which are metabolised in the liver, so it's not as simple as asking if it's a bad idea… it depends. What we're usually told is to moderate alcohol, 14 units a week spread over 3 days. If you intend drinking 14 units/week that equates to

Single small shot of spirits * (25ml, ABV 40%) 1 unit…

Alcopop (275ml, ABV 5.5%) 1.5 units…

Small glass of red/white/rosé wine (125ml, ABV 12%) 1.5 units…

Bottle of lager/beer/cider (330ml, ABV 5%) 1.7 units…

Can of lager/beer/cider (440ml, ABV 5.5%) 2 units…

Pint of lower-strength lager/beer/cider (ABV 3.6%) 2 units…

Standard glass of red/white/rosé wine (175ml, ABV 12%) 2.1 units…

Pint of higher-strength lager/beer/cider (ABV 5.2%) 3 units…

Large glass of red/white/rosé wine (250ml, ABV 12%) 3 units…

*Gin, rum, vodka, whisky, tequila, sambuca. Large (35ml) single measures of spirits are 1.4 units. nhs.uk/live-well/alcohol-su...

Generally, as long as you don't drink on MTX day, or the night before your drug monitoring bloods are taken. Best not to binge drink & be sure your liver results are stable before you start drinking again, but really the person you need to ask is your Rheumy I’m afraid. He's the one trying to keep control of everything including you tolerating your meds, not only side effects but how they may be affecting your liver & other organs. It's easy for me to say I know but I’d choose being well controlled over having to stop a med because of my liver values being high.

Another option is alcohol free or low alcohol drinks, there are many nowadays. I know because my h drinks those & only on occasion drinks alcohol due to liver & pancreas problems. Of course you don't get tipsy but if that's the reason you drink alcohol then I’m not sure you'd get tipsy on 14 units either, depending on you tolerance of course, I definitely would, hic!

Quick story, when I first started my meds I was asked by my Consultant to stop drinking as my liver values were high. He didn’t believe me when I said I didn’t drink alcohol or my h who he looked over to for affirmation for that matter! His response was that he only meant spirits, wine with meals & beer was ok! This was when I lived in Spain, different views on acceptable drinking of alcohol!

Pythagorus profile image
Pythagorus

Hi Langars, I have been on Methotrexate for 15 years and have a glass of white wine every evening. I have my bloods done every 3 months and no liver problems noted! If socialising I may drink a little more but I definitely don’t binge drink.My RA is well controlled on Methotrexate and Benepali and I lead I normal active life - long may it continue🤞

Enjoy getting your life back and appreciate all the more socialising with friends 🎈😊

Shelby37 profile image
Shelby37

Hello,Until recently I drank regularly, except on Mtx day and the day after, with no problems at all. I stopped drinking 3 months ago as my consultant has suggested I swap to Leflunomide, which is harder on the liver. A study conducted by Manchester University in 2017 shows that while the risk of liver damage in patients with RA taking methotrexate increases with higher levels of alcohol consumption, the risk in those consuming 14 units or less per week is no greater than those who do not drink. The newer advice, unless you have an issue with your liver is that drinking in moderation is okay.

Enjoy yourself, go out with friends but stick within safe limits.

Feank profile image
Feank

A little of what you fancy...don't overdo it, socialising is good , have fun and stay well. Plenty of laughter and dance like no one's watching! Enjoy. X

Ascidian profile image
Ascidian

My rheumy just said to be careful - strictly no more than the weekly recommended amount, NEVER binge, and never on mtx day. I decided to quit completely for the first few months to see how my liver coped with the meds. I was fine, so i do now drink some alcohol, but decided to limit it to 2 or 3 glasses of wine per week. I usually stick to one glass per night and on the rare occasions I have indulged in a second I have felt quite unwell (not drunk, just not right), so don't do that anymore. You will have to find your own limit, based on how you feel and how your liver enzymes react, but perhaps err on the side of caution.

Somehow it feels nicer when socialising to be drinking something that at least LOOKS like what other people are drinking. Also, I really don't like fizzy soft drinks or orange juice, so I have been researching alcohol-free versions of wine and beer. I have found that most bars and restaurants have at least one quite decent alcohol-free lager. There are also some quite good ales, at least one cider, and a couple of gins, and I have finally found a tolerable (just about) 0% red wine, but have only found these in shops so far. I am on a mission, though. Everywhere I go I ask what alcohol-free drinks they have. The more people who ask, the more likely they are to stock them in future. Good luck finding what works for you

Chockyuk profile image
Chockyuk in reply toAscidian

I’m with you, even though I don’t drink anymore, I have the no alcohol Peroni when I’m out with friends, it tastes quite good. I try and steer clear of the non alcoholic wine 😖 although there is a nice zero % Prosecco which is not bad, can’t remember the name now off hand.

I also drink the Fever Tree Ginger Beer, I love that.

Anything rather than the obligatory Coke or orange juice.

Ascidian profile image
Ascidian in reply toChockyuk

yes ginger beer is tasty, but the Prosecco doesn't appeal. I far prefer red wine to white and don't really like sparkling wine - even champagne. If I want a beer at home, I choose Doombar zero - less fizzy as it's an ale rather than a lager. The Artis red wine is the least bad, I find.

ElizabethW profile image
ElizabethW

When I was on MTX, I asked my rheumie and he said 3 drinks a week were ok, but not in the same day and not on MTX day, so I used that as my guideline. On one occasion my bloodwork showed elevated liver enzymes, so I stopped drinking any alcohol until the next blood test, which turned out fine. So for me, having a beer or a glass of wine in moderation was ok with MTX. I guess it depends on the person and what their overall health is like, and whether blood tests show that the liver is ok.

Chockyuk profile image
Chockyuk

I’m actually tea total, have been for about 13 years now, but I have a friend who is also on Mthx and he drinks, probably not to excess, but seems to have no liver elevation problems. 🤷‍♀️I on the other hand had really elevated ALT when I first started taking it, but now seems because I was on 40mg of Omeprazol for my tummy issues, now I’m on 15mg of Lansaprozal and my liver functions are back to being very low. My Consultant was always asking ‘do you drink’, it was quite annoying cos I never do. 😂

I’d imagine a glass in moderation might not be too bad if your bloods are normal, but maybe best to ask your Consultant for advice first.

jayne17 profile image
jayne17

Hi, I too have been on methotrexate for over 10 years and enjoy a glass of wine every evening. I rarely drink excessively and have no problems with blood results at all. This RA is bad enough without having to give up life's little pleasures.

wishbone profile image
wishbone

hic... :-O

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