Methotrexate

[13184]

Hi I just started methotrexate a month ago. I just got my labs done and my liver enzymes are normal. The doctors says I can only have one or two drinks a week. Does anyone drink any more then that a week and are your liver enzymes still normal? I like to socially drink … not a alcoholic. Just wondering.

[CJ-pmr15]

Cant help I'm afraid. I've been on methotrexate for 2 years but I stopped drinking because of the risks.

[DAW28]

I have been taking Methotrexate for nine years. I believe the recommendation is that you keep alcohol to a minimum as it can react with the Methotrexate and cause medically induced cirrhosis of the liver. Not long after I was started on MTX I was out with friends for a meal and the six of us were offered a little shot of Limoncello by the restaurant at the end of the meal. No-one else liked the Limoncello so I drank all six glasses. The next day I went for routine bloods and very soon afterwards my Rheumatologist was on the 'phone telling me to stop the Methotrexate and attend for repeat bloods in two weeks time. Clearly the alcohol had influenced the results. I never did own up to what I'd done but I have been very careful regarding alcohol and stuck to what's recommended ever since. I cannot advise you on what to do but thought my tale might help you to decide.

[MrsNails]

Hi I’ve taking MTX for a long time, the first time l took it l never touched a drop of alcohol- so concerned l was about the side effects & risks to my liver. I was taken off MTX for Surgery followed by Chemo, returning to MTX after 14months however, this time due to my Cancer diagnosis, l’m afraid a glass of wine did not go amiss, not that l drank much but l certainly was a little blaze than previously.

Unfortunately for me l developed a Fatty Liver (NAFLD) caused by the Steroids so my MTX was stopped.

Eventually, when l’d lost two stone & reversed my liver enzymes l returned to Full Dose MTX but l don’t drink except on very special occasions. 🥂

If you look in FAQ - there’s pretty much my whole MTX Experience.

Kind Regards

MrsN

[PMRpro Ambassador]

Everyone is different so while it might be fine for one person it may not for another.

I often feel quite sceptical when someone says they "only drink socially" - it isn't WHY you drink, it how much you drink and the smallest measure of wine in the UK is 125ml, not the equivalent of 1 unit of alcohol at all - since UK wines seem to be pretty high alcohol compared to what we drink here. A bottle of wine is well in excess of 10 units. One small glass (110ml) of wine with dinner and a prosecco on Sunday takes me to the recommended 14 units per week and it really isn't the way I see people in the UK drinking "socially" because you lose count so easily.

[Hidden in reply to PMRpro]

I must admit the first time we had a meal in Italy and I ordered a glass of wine, when it arrived I thought it was a taster. The large glasses we drink here in UK are obscene really by comparison to other parts of Europe, I feel ashamed of us Brit’s. In my humble lay opinion the only reason to have a drink is if you fancy one and that should be only if your medics, medication and malaise allow. It is after all proven to be bad for us like tobacco and look where we are with that now, in another twenty years maybe the young will say ‘you used to drink alcohol’ and they will be shocked!

[PMRpro Ambassador in reply to Hidden]

I think a glass is 100ml - and for posher wines or in many bars the morning glass while reading the paper Here you order a glass (everyday open wine is a euro for that) and if you want more you order a carafe which will be 200ml or 250ml depending on the house predilection. No-one considers it a cheek to order a viertel (quarter) of a litre and 2 glasses. Apart from that though, few people drink wine without food as they do in the UK. Out here in the country you rarely see drunks lying around - so different from the UK.

[Hidden in reply to PMRpro]

I freeze fruit, fill the glass with it, add still or fizzy water, leave to infuse and drink. Sometimes I even use apple or carrot peel even, makes me feel good about the planet too. Plus water is better for IC surely?

[PMRpro Ambassador in reply to Hidden]

You'd think!!!

I've taken to cutting thick slices of untreated/organic oranges and freezing them - much better than ice cubes in an aperol spritz!!

[Hidden in reply to PMRpro]

Cheers!

[Suet3942]

When I started taking mx the consultant was adamant that I shouldn’t have any alcohol. A few months later I saw the rheumy nurse and she said a couple of glasses of wine shouldn’t hurt. I have been on mx for about 5 years, have a couple of glasses of wine at weekends and so far my liver is still ok. She advised not to go for a blood test within 48 hours of having any alcohol. Fingers crossed it continues.

[PMRpro Ambassador in reply to Suet3942]

The not having alcohol the night before a test applies permanently!!! Gets some doctors very uptight - like my GP!!

[Maisie1958]

Hello 13184 I’ve been looking at this post with interest as about to take my 4th lot of MTX tablets tonight and going for my second post meds blood test later in the week. When I asked my rheumie nurse about alcohol he said most people are ok providing they keep it under the advised 14 units a week. I’m still being cautious and it does seem to be a very individual thing. So far I’ve been absolutely fine on 15mg of MTX, early days and am a bit wary of rocking the boat but there’s certainly something very nice about a G&T or prosecco. Any tips on tasty non alcoholic beverages welcome.

PS you might get more replies also posting in the NRAS forum. All the best

[PMRpro Ambassador in reply to Maisie1958]

I'm told some of the non-alcoholic gins are not bad! Can't try them though as if you look for non-alcoholic alcohol substitutes here they obviously think you are totally nuts!!!

[Maisie1958 in reply to PMRpro]

😂 yes I can see that living where you do! I’m just trying to use smaller wine glasses atm…my nice everyday (before DMARDS) ones could hold a good third of a bottle and more …🤫🤭

Luckily some of the fancy tonic waters taste nice on their own.

[PMRpro Ambassador in reply to Maisie1958]

I have beautiful German Romer 250ml glasses like you get in southern German pubs - they became far too tempting. My "free with Esso petrol" glasses from about 35 years ago are a perfect 110ml! Get 6 days wine with dinner - and Sunday is a mini prosecco I currently have a glass of Gordon's ultra low alcohol G&T in my hand - which I found in the fridge, Must be 2 years old so needs drinking. But it doesn't taste too bad at all!!!!

[Maisie1958 in reply to PMRpro]

Enjoy 🥂