Should patients drink alcohol whilst taking long-term low-dose methotrexate?

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Gunner Wiegand asked a question: Should patients drink alcohol whilst taking long-term low-dose methotrexate?
Asked By: Gunner Wiegand
Date created: Wed, Mar 17, 2021 8:43 PM
Date updated: Thu, Jun 30, 2022 1:40 PM

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Should patients drink alcohol whilst taking long-term low-dose methotrexate? – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice This Medicines Q&A reviews the evidence that alcohol increases risk of methotrexate-induced liver toxicity, and advises on safe levels of alcohol intake by patients taking…

This Medicines Q&A reviews the evidence that alcohol increases risk of methotrexate-induced liver toxicity, and advises on safe levels of alcohol intake by patients taking…

A: Patients can drink alcohol while taking long-term low weekly doses of methotrexate (25mg or less), but they should limit their intake. Evidence suggests that consumption of alcohol increases the risk of liver toxicity.

For its part, the American College of Rheumatology says “methotrexate should not be taken if kidney or liver function is not normal. Alcohol significantly increases the risk for liver damage while taking methotrexate, so alcohol should be avoided.”.

The current uncertainty, Dr. Dixon said, “means that patients often avoid alcohol altogether, or avoid methotrexate if they want to continue to drink, even modestly.” The authors cautioned, however, that their findings should not be generalized to other populations.

methotrexate in patients with a history of alcohol abuse, but do not specify any restrictions to alcohol consumption in patients taking methotrexate (25). By contrast, the American College of Rheumatology (ACR) guidelines take a cautious approach similar to the manu-facturers and advise that alcohol should be avoided whilst on methotrexate (26).

So technically, it’s probably not a good idea to drink any alcohol while taking methotrexate. That being said, drinking one standard glass of alcohol once a week probably is safe. This is a bit of a touchy subject, and you should discuss this more with your doctor.

There are several Medicines Q&As on the Specialist Pharmacy Services website about the use of low dose methotrexate including: Should patients drink alcohol whilst taking long-term low-dose methotrexate?

Avoid drinking alcohol while taking methotrexate. Note that this list is not all-inclusive and includes only common medications that may interact with methotrexate. You should refer to the prescribing information for methotrexate for a complete list of interactions.

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