One of the most effective medications for rheumatoid arthritis is methotrexate. As a matter of fact, it is the first drug prescribed if you are diagnosed as having rheumatoid arthritis.

Methotrexate is generally prescribed on its own or along with other medications.

Methotrexate and Alcohol

The first advice that your doctor will give while prescribing this medication is cutting down or avoiding alcohol. Now that is one shock that you might not be prepared for.

Doctors advise avoidance of alcohol while taking methotrexate because both affect the liver and a combination of both increases the chances of liver damage.

While a person can tolerate methotrexate, it has been linked with various adverse events related to the liver including a mild increase in blood level markers, fibrosis and, in very rare cases fatal hepatic necrosis.

Arthritic patients are at an increased risk of having liver damage, and drinking alcohol does make them susceptible to further damage.

The type of arthritis might also be a factor in determining how methotrexate and alcohol interaction affects the liver.

For instance, psoriatic arthritic patients being treated with methotrexate have increased chances of liver toxicity compared to rheumatoid arthritis patients. Scientists have not yet been able to understand the reason for this.

Avoiding Medication To Enjoy

Lack of guidance on the amount of alcohol that can be taken by people while being on methotrexate led doctors asking their patients to avoid using alcohol while taking this drug.

This, however, leads to some patients opting for other medications so that they can still enjoy that drink. This results in them not benefitting from methotrexate.

Some totally avoid drinks once they are prescribed methotrexate because they believe that drinking in moderation might affect the quality of their social life.

Light at the End of the Tunnel

But there is light at the end of the tunnel.

A study conducted by The University of Manchester and published in the Annals of Rheumatic Disease analyzed records of 11,839 rheumatoid arthritis patients.

The data was collected from the UK general practice database - Clinical Practice Research Datalink.

In this study, participants took methotrexate and six LFTs in a year. The study showed that only 530 patients developed complications after taking alcohol along with methotrexate.

Researchers found that while there were chances of increased liver toxicity, those who took less than 14 units had no evidence of heightened risk.

According to researchers, having a pint of beer, which contains 3 glasses or a glass of wine (250 ml), which included 3.5 glasses, did not necessarily increase the adverse risks.

Researchers found that patients who had about 15 to 21 units had a 33% higher chance of suffering from liver damage. This figure rose to more than 81% when the number of units increased from 21.

Researchers concluded that drinking in moderation not only allows the patients to enjoy their social life but also benefit from methotrexate.

Doctors across the board have accepted this study. They believe that this study helps in defining the risk of liver hepatotoxicity for different alcohol levels. This study also helps in quantifying the risks which helps doctors in guiding their patients when it comes to taking alcohol along with methotrexate.

The Final Word

Deciding whether to reach for that glass of wine or beer while taking methotrexate boils down to having a frank discussion with your doctor.

The key here is honesty between the doctor and the patient. One should not feel intimated while discussing these topics.

Your doctor has to understand how important having a good social life is for you, and having that discussion can help him or her to determine how much you can have based upon your health history.