Methotrexate

[Petertaffy]

Is there another alternative to Methotrexate for people who likes to have few pints of beer?

[J1707-]

I have always drank on MTX . Been on it 7 years If bloods ok you can still have a few beers.

[Petertaffy in reply to J1707-]

Thanks for your message

[jarujuda in reply to J1707-]

Me too 🥂

[bpeal1]

Not really as all RA drugs affect the liver. How many is a few? What do your blood test results look like? Speak to your rheumatology team if it’s really bothering you and see what they say. If your liver is coping well with the methotrexate they may be happy for you to drink in moderation.

I have it on good authority from my husband that many of the low/no alcohol beers are very good now.

[Petertaffy in reply to bpeal1]

Thanks for the reply. About 2 and 3 pints a day

[bpeal1 in reply to Petertaffy]

Think you need to speak to rheumatology and ask their advice.

[MidWhitgiftian in reply to bpeal1]

Not advertising BUT, Guiness Zero is good if you like "Stout" beers.

[OSTEOARTHRITISRA]

Hi it would be the same with other medication .You can have a few pints

[Runrig01]

My rheumatologist allows me to drink up to the 14 units a week, as my liver blood tests are always fine. Maybe try switching some of your beers to low alcohol.

Most beers are about 2.5 units in a pint, so I don’t see your rheumatologist agreeing to 5 or even 7.5 units a day. Alcohol is also inflammatory and will make it more difficult to get your inflammation down. There are many good low alcohol options available these days.

[Colaba in reply to Runrig01]

How do you get to know your liver blood test levels?

How do you know you have had liver bloodtests?

I have frequent bloodtests but never know what for and have never been told any results.

I hope that if anyone else knows and there is a problem they might tell me.

I drink small amounts of wine, occasional beer and very rare whisky.

I have no relationship with any any 'team' and have seen no rheumatology professional

for more than two years. I am very old and slowly declining. 'C'est la vie.'

[Runrig01 in reply to Colaba]

Most gp surgeries have apps that allow you to view your blood results. NHS app also allows this if your gp has approved. I assume you’re under rheumatology as it’s only them that can prescribe MTX. The tests that are generally done are:

FBC - full blood count

U&Es - urea and electrolytes including glomerular filtration rate. These are related to your kidneys.

LFT - liver function tests

CRP - inflammatory marker

ESR - inflammatory marker

Everyone on MTX should have these tested.

[Colaba in reply to Runrig01]

Thank you very much for this. Nobody has ever told me any of that.

[StateOfPlay]

I was told I could drink in moderation. I like a pint every now and then, I can go weeks and months without a drink. My blood test results "Liver Function Test" started to go up on my first anniversary of taking Methotrexate, and my GP said it is likely to be a problem with alcohol. He is wrong, the last pint I had was in July, but he made it clear he was sceptical about my claim!

I stopped Methotrexate 2 weeks ago and will have another blood test this week to see if it is the Methotrexate causing the problem. I'll let you know what the outcome is.

[smilelines in reply to StateOfPlay]

Oh……..that is interesting. Same thing happened to me on leflunimide.

[smilelines]

Sadly you gotta just cut back especially when you start the methotrexate. Don’t go over what your doctor recommends. There is a reason why they take your bloods often and that is these drugs are dangerous. Once you see how your body reacts you can indulge more. Unfortunately all dmards are not good for your liver. I hope you can find a tasty low alcoholic beer.

[Gilliancheche]

I would add another vote for alcohol free beers. Most places stock at least one these days. Some even have on draught. For most of us it isn't just the actual beer, it is the social aspect.

[Hightower62]

I agree with all the comments regarding low or zero alcohol beers, some really good ones out there. I also really enjoy a nice red wine but sadly the zero or low alcohol versions are nothing like the real thing and taste like grape juice so I don’t waste my money.

Consequently I drink zero alcohol lager or Guinness but have carried on drinking a nice red wine in moderation with no adverse effects in terms of how I feel or liver function which I personally find to be a good compromise that works for me.

[GinnyE]

How I wish there was! I keep to 14 units a week, so for you, that would mean about one pint a day for six days (not methotexate day). Having to count and moderate takes out alot of the fun. And if you're with drinkers it's hard. Still, I don't get their rotten hangovers anymore. I try and lecture myself on how much pain I was in before the methotexate so as to keep perspective. Still a bit mardy though.

[Lifesforliving]

I always drank - in moderation - whilst taking methotrexate and my bloods stayed within limits except when I went on all-inclusive holidays and the outcome of excess alcohol consumption certainly showed up in my blood test outcomes.

However, after taking MTX for about 12 years I had a fibroscan in August 2023, which showed that I had quite pronounced liver fibrosis (F3 on Metvir scale) which was a wake-up call. I was taken off MTX in October 23 as a result, but I also gave up drinking alcohol since last January. A recent repeat Fibroscan showed my liver now to have returned to within normal range (F0/F1 on Metvir scale). I still don't know whether the fibrosis was due to the MTX or alcohol, or both, but what I would say to you, and to everyone who takes MTX and enjoys a drink, is that you shouldn't just rely on the blood test results alone as an indicator of liver health/tolerance.

[Neonkittie17 in reply to Lifesforliving]

Really honest and helpful post/info. You’ve said exactly what I thought .. the blood results arent always the full picture. I’m glad to hear your liver has returned to normal. Great news.

[welsh12 in reply to Lifesforliving]

Did you have the scan because you had some health issues if there were no problems with your liver blood results

[Lifesforliving in reply to welsh12]

Yes, I'd experienced a random cramping pain in the vicinity of my liver. and underwent a whole series of investigative tests of which the fibroscan was one of the last to be conducted. The liver fibrosis diagnosis was not a factor in respect of the original complaint of pain, but a separate and much more significant outcome which led to the gastroenterologist emphatically recommending rheumatology to cease treating my RA with MTX, and it was immediately withdrawn. We all react differently to drugs and it might well be that my experience would not be replicated in somebody else.

The point I was making earlier was that getting satisfactory results from routine liver function blood tests is no guarantee of what is actually happening, so using this as a yardstick that it's OK to carry on drinking should be viewed with caution.

[marti]

I've always drank on methotrexate my consultant told me as long as I stayed within the recommended units and it wasn't affecting my bloods he didn't have a problem. 16 years on I'm still enjoying a few beers at the weekend. I know some people can't seem to tolerate alcohol on methorexate but I've never had a problem.

[D_aisy]

I think it just boils down to our livers capabilities. I have 2 friends with RA we’re all on different drugs and they can drink a few times a week or get bladdered at Xmas with no effect. I on the other hand can’t sniff a Xmas pudding without my liver screaming for help! I’ve been dry for 4 years now.

My dr unofficially tells me to have a few weeks off injections and have a tipple if want to now I’m well controlled but I think I’d be a drunken mess 😂

[Feelingpoorly]

Hi I like to have a drink but keep to 14 units per week….so far so good! I take my MTX on a Wednesday so I have a drink on Friday /Saturday and Sunday (sometimes a couple on each of those days, sometimes drinking just one night depends of my social life).

When on holiday or over Xmas etc (and if I feel stable) I will usually drop methotrexate for a week so that I don’t have to worry about having a drink on any particular day.

Hope that helps 😊

[KASHMIRI1]

I have been told not to drink any alcohol while taking MTX and have stuck to that as I feel my body has enough to cope with having GCA and a whole raft of other drugs that I didn't take prior to GCA