Leflunomide and alcohol

[PastelsinArt]

I'm in a transitioning stage between Tociluzumab and Leflunomide to help with PMR and GCA while very gradually tapering my Pred and trying to avoid any more flares. I'm using the last few TCZ doses every 2 weeks and taking 10mg LFM daily. I've been on it for 4 weeks now. I managed to avoid the dreaded diarrhea which I was warned about, but what I wasn't expecting was the Do Not Drink Alcohol instruction on the bottle of LFM pills. I've only had a couple of glasses of wine (had to drink a toast to the Queen at the Jubilee, of course!) in the 4 weeks. Can any of you knowledgeable people tell me just how strict this no alcohol rule is, please? I'm having blood tests every 2 weeks at the moment, and have heard nothing re the results, so assume they are OK. (Rheumatology at Leeds are usually pretty good at getting in touch if they spot a problem).

[DorsetLady PMRGCAuk volunteer]

This from Patient Information Leaflet -

“Leflunomide with food , drink and alcohol

Leflunomide may be taken with or without food.

It is not recommended to drink alcohol during treatment with Leflunomide. Drinking alcohol while taking Leflunomide may increase the chance of liver damage.”

Can’t comment, never taken it, but the drug can affect liver anyway, it’s a recommendation.

Sure others who do take it will be along shortly.

[Maryis80 in reply to DorsetLady]

My rheumatologist said ok to drink alcohol in moderation and he checks live and kidney function when I have a blood test before seeing him

[PMRpro Ambassador]

Like most things, I imagine a small glass once in a while is fine - the liver is very clever at regenerating if you give it a few days alcohol-free. So I looked it up:

versusarthritis says

"It's recommended that you only drink small amounts of alcohol when taking leflunomide, or that you don't drink alcohol at all.

As a guide, you shouldn't drink more than four units of alcohol a week while taking leflunomide"

A 125ml glass of normal wine is 1.5 units

versusarthritis.org/about-a....

[PastelsinArt in reply to PMRpro]

Thank you, that's helpful. I'll try to stick to that till I see Dr Mackie later in July. She will have had several blood results by then too.

[PMRpro Ambassador in reply to PastelsinArt]

Don't know how easy it is to get lower alcohol wines in the UK - not the alcohol-free stuff! Get perfectly acceptable Italian and German wines that are less than 10%

[PastelsinArt in reply to PMRpro]

Will research and report back! I found an alcohol free beer that's ok, but I do prefer wine.

[PMRpro Ambassador in reply to PastelsinArt]

My daughter does tolerate no-alcohol wine but I haven't been in the UK to try. Ask for no alcohol here and they look at you as if you are from outer space!

[PMRCanada]

You’ve received some great responses. Very informative.

When I started Methotrexate my rheumy and I discussed alcohol consumption and sun exposure. No problem regarding alcohol (I’ve only had two cocktails since starting the medication Jan 3). However I truly do love the sun and enjoy time outside with our pool in the summer months. Now I’m under the shade umbrella instead (which I know is safer/better for me). Oh the adjustments we make.

[PastelsinArt in reply to PMRCanada]

Yes, HU is a wonderful resource, really appreciated. And yes, we do have to make adjustments, don't we! Worth it to live with the benefits of modern medicine though.

[Skysey]

I am on leflumonide and haven’t had any alcohol for about 3 years. I have GCA and another autoimmune condition that can affect my liver. As Dorset Lady said, the information sheet says drinking of alcohol is not recommended. However, if your blood results are fine it should be ok to drink small amounts of alcohol. Please let us know what your rheumatologist advises. I have got used to not drinking alcohol but occasionally miss a glass of red wine! 🍷

[winfong in reply to Skysey]

Had to give it up for several reasons. Really don't miss it at all.

I have had a glass or two on holidays, special occasions, etc., but it really doesn't do anything for me anymore. I figure I'm tired and dopey enough on my own. Don't need any extra help with that.

[lindyloy]

Hi, I am also a patient at Leeds Rheum. and was taking Leflunomide for quite a while. The instructions on the medication said no alcohol, so I didn't dare have any, I was quite relieved when I started on TOCIL. and I was told I could have the occasional tipple!