Methytrexate and alcohol

Depends on how much you value your only liver. And make no mistake, I did enjoy my very old single malt scotch and a very big Cabernet.

I was on Methotrexate for RA between 2011 -2018i started at 22 mg and over time as my liver enzymes rose, I cut back and back until I was too low to prevent developing antibodies to Humira, the primary biologic I was on. So I went on Enbrel instead of Humira, and began methotrexate as an injectable instead of pills to try to bypass the degree to which it was being metabolized in the liver.

At the end of the day, my liver said enough and I had to change to an anti-TNF biologic i have infused every six weeks. No Methotrexate. My liver enzymes are ok today, but I do have some liver damage that won’t resolve. Consequently I now enjoy one, maybe two drinks a week. So I buy the really expensive stuff now 😁

There are alternative meds as I described. But the insurance companies like methotrexate because its inexpensive.

It’s not as if I was even drinking everyday. But its just a lot for your liver to handle.

We are just fellow patients, so this isn't medical advice - just personal advice. Be prudent. Again - you only are issued one liver and its’ primary job is to filter substances it sees as poison - which is how it sees alcohol. And methotrexate. Challenge it too much and you will hear from it.

Good luck!

I take 8 methetrixate once a week and drink wine with dinner for a year. I also drink plenty of water all day long. I have a blood test once a month to check kidneys and liver. All is normal so I think I am ok.

I love this reply❤️At 76 I definitely enjoy my evening wine… Thanks

Thats great! If memory serves, each tablet is 2.5mg -so 20 mg a week? What RA med are you on?

Yup! 8 methetrixate a week. And plaquenil 200mg twice a day and folic acid once a day except when I take methetrixate. I am 75. Exhausted with pill taking. I work out every day...in good shape. Just living my life!

Well the good news is that as long as you are monitoring liver enzyme levels, if they do start to spike, you’ll think then about discontinuing the methotrexate and it will drop almost immediately.

I will keep monitoring my liver and kidneys function every month. So far so good!

5 years in with PMR AND GCA. GCA in remission or gone for good.🤞Just put on MTX with tapering Pred 15 mg 👇very slowly .I realize alcohol while in MTX is not recommended but I have a very active Social life and wine is definitely a very enjoyable part of it.
At 77 years old I want to continue doing what I like and not worry about impending liver damage. If I was in my 50’s I think I would be more diligent about the alcohol restriction . Any thoughts on this appreciated.

I do not have much of a social life but always liked having a glass of wine with dinner. I'm now taking pills at every meal and alcohol is not an option for me. For awhile I was buying Welch's sparkling cocktail, different flavors, and pouring it in my favorite wine glass at dinner time or while cooking. I gave up on that because of the sugar but will still buy a couple bottles during the holidays. There's non alcoholic wine I think and don't most restaurant drink menus have fancy cocktails without alcohol? My advice to myself has been to only have a very occasional glass of wine to celebrate something special.
Moderation is what works for me. I'm 75
and not willing to give up 'everything' I enjoy eating. Foods I should not be eating I go with the 'three bite rule'. Never thought about a ' three sip rule'.
For now, I'm okay with my limited indulging.
My opinion is to keep using your wine glass filling it with non alcoholic facsimiles as much as possible.

If you are concerned about alcohol and your health
conflicting with social drinking there are options.
I saw the need to cut back with the newer thinking on inflammation and concerns about my cognition in my 70’s.
I limit my intake to a drink every second or third night.
Without empty calories it helps to control weight.
Socially I am very comfortable with tonic and a lime
in hand. I have really acquired a taste for Bud Zero
and some of the non alcoholic IPA.
Dry January is usually a slow social month.