Methotrexate and Alcohol - - Need some advice ASAP!

Ok look, I know what the rule and Doctor's orders are about alcohol and Methotrexate are, but I need some answers and opinons.

It's Labor Day weekend and I haven't had a drop of alcohol since I started the drug on August 14th. I know that doesn't seem like very long, but before I started the drug I usually drank 3 to 4 times a week. I'm going to be painfully honest here, because I can't get the answers I want with out doing that. . . . I am on 12 mg 1 x a week. Just took a dose Tuesday. I am a 27 year old female who is 5'9" and weighs 195lbs. When I drink on the weekends at get togethers with friends, I tend to drink quite a bit. I stick to beer (Miller Lite for example), but I can drink anywhere from 10 to 15 beers by myself, depending on how long we are all hanging out and what we are doing.

Sorry there is so much detail here. I just want to go have a good time with my friends and boyfriend this weekend and I'm so sick of everyone telling me how bad they feel that I can't drink. I enjoy drinking. I enjoy being able to let loose. Most people would usually respond on here by telling me to have one or two. . . I know me and know that won't be an option.

So here are my questions for those who are on or have taken Methotrexate:
1) Have you drank and over indulged (even if it was just once) while on the meds? If so, were you ok? Did you have a bad hangover? Did you feel like you messed your liver up? Did your blood work come back bad?

2) Should I just suck it up and drink water or whatever like I've been doing for the past 2 1/2 weeks?

Any advice?

I can have a good time without drinking, but I don't want to this weekend!

Like I said, I've only been on the Metho since August 14th and supposedly, I'm only going to take 4 total doses, so this Tuesday is supposed to be my last. My Dermatologist just put me on it because my insurance requires that before they will approve a Biological.

Thank you in advanced to those who may be able to help me out here!

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I have been on MTX for 3 years now and I only have the occasional drink and never more than 2 at any one time. Honestly I am scared to death to risk it, Liver damage is no joking matter and really would you want to find out that your Liver can't take it anymore and not be able to take any meds for the PA?

As for this weekend if you can trust yourself to just have 1 or 2 beers or whatever then do so and then follow it up with a lot of water to flush it through your system, if you don't think you can stop at 1 or 2 then don't have any at all, it's not worth risking your Liver.

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Thanks realtor910, that's how I feel too. I'm scared to death. I love drinking and told my Doctor that before she put me on it. To be honest, I know it's only been a little over 2 weeks, but I have seen NO benefits to the drug yet. . . I am greatful I've only had a few side effects (mouth sores and an occasional headache and then I can tell when I am dehydrated cause I get shooting pain in my kidneys, not severe, but enough to feel it) .

I have my next appointment on Sept 12th with the Derm.

Maybe I'll just have a glass of wine that I can sip on followed by water water water. . . Probably nothing though :-(

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SweetDixieDoll:

MTX can take up to 3 months to reach full efficacy so be patient. You must drink tons of water all the time while on this drug, so drink up. Mouth sores can be avoided by taking enough folic acid along with your MTX, how much folic acid does the doctor have you taking? I take 1 mg every single day some doc's suggest up to as much as 5mg so ask your doctor or Pharmacist about this. You can help relieve the mouth sores by rinsing with warm salt water and the other reason that is so important to do this and to drink the water is to protect your teeth. Dry mouth leads to Dental decay and suppressing your immune system with MTX only adds to the decay problem so drink the water, stay hydrated and please keep up with regular oral health care, see your Dentist regularly please. I know this from first hand experience and no warnings, I just had to have 3 teeth pulled because they just literally became so weak that they cracked am now getting a partial, I had really nice teeth and I am heartbroken over this, so please heed my warning.

I think 1 glass of wine to celebrate and then followed by water, water, water sounds like a plan and is what I will probably be doing! : )

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Hi SweetDixie, I feel your pain. I also miss having alcohol in my life. When my P became severe I became a raging alcoholic, but that was to self medicate for the emotional pain I was going through. Before then I was a social drinker, and drank almost daily in the evening while I made dinner and then with dinner. The relaxation that alcohol brought me always felt good and I looked forward to it.

MTX takes a while to work, it can take a couple months before you start seeing results. Also, you are being started on 12mg, it is likely that this dosage will be increased if you are able to tolorate it and are not seeing results.

So I take 15 mg per week and have mostly quit drinking. I do very occasionally partake and will have a couple glasses of wine but that is it. About two months ago my husband and I went to Reno to gamble and what was supposed to be a couple of drinks turned into many drinks. I would say that I drank quite a bit that night and had a terrible hang over the next day. I also felt worried about my liver. I had blood work done two weeks later and it was all good.

I've done a lot of research and reading on liver health (and health in general) and the effects of various things such as alcohol, methotrexate and others. My conclusion is that first and foremost we need to support the health of our liver through nutrition, namely, dark leafy greens (esp. Kale), cruciferious vegitables, and dark and bright colored fruit (such as raspberries, blueberries, black berries etc.). Alcohol should never be consumed on an empty stomach, and nutrition can help mitigate the stress it puts on the liver. Additionally, methotrexate is not metabolized by the liver, but does tend to accumulate there.

I'm including two links. The first is an article that does a great job explaining what research says about MTX and it's effects on the liver. The second link is an blog written by someone with RA who is discussing this very subject. At the bottom of the blog there is a link where you can read the 70+ comments on the blog. It is very interesting to read, as many of the people responding talk candidly about their alcohol consumption while on MTX. Many of the responders feel that alcohol is okay to consume while on MTX. I know that alcohol is a poison to your body and the liver has to work hard to detoxify it, so I do not think heavy drinking is good for anyone, but it seems that not everyone agrees that the alcohol/MTX combo necessarily amplifies the damaging effects of alcohol alone.

http://doctorakerkar.wordpress.com/2011/03/20/methotrexate-does-it-harm-the -liver/

http://rawarrior.com/methotrexate-and-rheumatoid-arthritis-is-alcohol-consu mption-safe/

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Don't do it. Its almost your last dose anyway. There will be other weekends.
OR
Don't take the drug! Since you are only taking it for insurance purposes nobody is going to know.
Although, 10-15 drinks will affect your health regardless of the fact that you are taking methotrexate. Just saying...

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My doctor said something like 2 drinks a week (or month). Since then, I've gotten off of MTX and I'm on Enbrel now. There's no prohibition on alcohol for Enbrel.

I quite good about the drinks because I was worried that if I damaged my liver at all, I would have to stop taking the MTX, and at the time, that scared me.

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The big interaction between methotrexate and alcohol is in regards to your liver. Normally your liver is capable of amazing feats of regeneration when you damage it. In fact, it is better able to heal itself than most any other part of your body. This is why you can binge drink and not die: because even though you are seriously hurting your liver, it can repair itself pretty well. The problem with adding methotrexate is that it is also relatively hard on your liver and more importantly it reduces your body's ability to repair itself. So the big problem here is that binge drinking is going to hurt your liver and then your body is not going to be able to fix the damage as well as it normally would. If you do this often, it might result in liver failure (which is a terrible way to go). In all honestly will binge drinking while on methotrexate ONCE be the end of the world? Probably not. But there is a small chance that it could be. It is up to you as to where you priorities lie though.

Here is a good analogy: Will driving home drunk ONCE kill you? Probably not. Is it a good idea? Nope. Is there a lot of risk involved in doing it? Sure is. Can it kill you if you keep doing it? Yep.

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It's not worth it. Just consider what's more important to you.. a few good drinks with your friends, or staying off a liver transplant waiting list? I just graduated from college, and for the last 6 months (right after turning 21, mind you) I was on MTX and was not able to drink with my friends and have a good time like the rest of my graduating class. But I was ok with it. Why? Because I'd rather be sober at a party with friends, rather than indulge once in awhile and end up with severe liver damage. There will be many more labor day parties and fun nights with friends, but you only have one liver, one body, one life.

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I have been on MTX for four months and used to drink white wine on the weekend.I have had two glasses after being off it for three months to see what happened and my blood came back ok no difference. Funny thing is I don't like the taste of it now since being on the MTX so stopped having it.I have found some really nice de-alcoholozed sparkling wine that tastes like champagne and looks like it and took that to a party and no one knew the differenece.There are options out there as there is a good selection of those type wines and I have tried three so far and like one better than the others.I asked this question before and one man told me he is a big drinker on MTX for 15 years and still here but I wouldn't do that.

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If alcohol wasnt around what would you do then i see you are more worried about getting a buzz rather than calming your p thats fine but if your worried about getting rid of your p i would quit a million bad habits to get rid of this disease i dont drink at aall and p is still covering a good80% of my body just started the paper work and tb testing for enbrol and if there r any bad habits my doc would like me to quit i will in a heartbeat your friends should understand and if they dont or cant maybe you should try a different set of friends i would b more concerned with my p than getting buzzed on the long weekend and alcohol will depress you in the long run i hope you willconsider my advice and not rebel we r all friends here so dont think i am scolding you im just trying to help

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Realistically it isn't a one time thing. Drinking heavily regularly causes a chemically induced depression. Your body interprets the excessive levels of dopamine caused by the alcohol as a failure to properly regulate dopamine so it shuts down dopamine receptors to compensate. Dopamine causes the sense of euphoria, happiness. Eventually only drinking will raise dopamine levels high enough to make you feel happy. Thus the reason you want to drink at this party.

It takes about two weeks for your body to start thinking maybe this problem is fixed. It then start reactiving those dopamine receptors slowly over a long period of time. Eventually you're back to as though you never drank. If you binge drink it's going to say, oops, we were wrong. So if you binge drink at this party you're just prolonging the agony. You are delaying the process of ending that chemically induced depression.

That has nothing to do with the "evils" of drinking, the cognitive impairment, lack of motor skills, slowed reaction time, the toxicity of alcohol for the body. It's just the euphoric feeling when you first start drinking. Particularly when you first started drinking. When you first start a couple of beers and you're real happy. Don't drink at all, or just drink in moderation, and eventually a couple of beers will do the same it originally did. You won't "feel" like drinking 12-15 beers because a couple will be enough.

Personally, I drank a whole lot for a whole lot of years. I was drinking about a 12-pack a night when I quit. It was far easier to quit understand just what was happening. Really, when it comes right down to it you condition yourself out of enjoying alcohol. There's just a limit to what alcohol can and cannot do. Seriously? If I just drink occasionally then I can just have a few beers at those special occasions and enjoy them a great deal more? No, the first Thursday, Friday, Saturday and Sunday are not special occasions.

If you're going to continue drinking get off the MTX. If you're going to quit drinking then do so. Do not drink this weekend. Next Labor Day you'll be able to drink in moderation, but not this one. This one will set you back. You have to look at the big picture. Getting all focused one day will put your right back where you were. If that's what you want to do then that's your choice, but if you're going to do that get off the MTX.

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Thank you all for your advice! I went an bought some Odoul's and had a few. All our plans for the weekend ended up getting cancelled anyways, so there was no pressure from any one. As far as some of those who commented about people who pressure not being real friends. . . I didn't mean that any of my friends pressure me. . . . it's more that I pressure myself.

At any rate, I ended up not feeling good on Sunday night. All symptoms are pointing to gallbladder issues. . . . but I'm not sure. When it rains it pours.... (sigh) I'm going to go post a different discussion about that stuff. Hope you all had a great weekend!

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