I amcurrently on Methotrexate 20mg once a week, and sulfasalazine. Has anyone had any experience with drinking while on these? I am going on a holiday in April and want to have one or 2 cocktails, not drink to excess. I am very wary though.
Thanks in advance!
SPS
Yes, I’ve been on MTX and sulfasalazine. The North American advice is that you shouldn’t drink with MTX. In other countries, though, they have different advice: our British and Australian friends have very different guidelines. Some places, you can drink with moderation. Others, nothing for the first three days after your mtx dose. It really does vary. I abstained completely, and then my rheumie switched me to mtx and arava. Her comment was “With mtx, you shouldn’t drink. With Arava, you MUSTN’T drink.” So what does that tell you? It told me that a very moderat alcohol on mtx would have been OK."
On a holiday, I think one or two cocktails are not going to send your liver into arrest. Enjoy the vacation!
The MTX is metabolized by the liver and excreted, mostly, by the kidneys.
Sulfasalazine must have effects on your liver or you wouldn't have to have a liver function test.
I'm sure your Dr told you not to drink. I'm sure YOU know you know you shouldn't drink.
Is it going to kill you? It might. Today? Probably not. Would I drink a few? If I wanted to. Would I regret it? Most definitely.
The easiest thing to do is drink 12oz of water (or more) every time you have a glass of wine or can/bottle of beer.
SPS, I see you’re in Oz. Ask your doc. I’m betting that your Aussie doc will be more lenient than our North American ones.
I was told I can have 2 drinks two days before my next dose by my rheumy, which is Wednesday, so I pass on the alcohol.
My Rhuemy says a few drinks a week is ok, ONLY if they are more than 3 days (72 hours) after the dose, and not within 24 hours of the next dose. MTX has been shown experimentally to be out of your blood (though interestingly they can still detect it in synovium of peripheral joints) in 72 hours. It’s pretty hard on the liver though, so for me it makes sense for it to be 4 days, giving the liver a day to “rest” so to speak, between assaulting it with MTX and alcohol.
Once the SEs on my MTX reduced, I started taking it on Tuesdays so I could have a couple of wines on the weekend if I felt like it.
I don’t have experience with sulfazalazine though - if you have a chance to ask your Rhuemy that’s always best, but you could probably look it up if you had to.
SPS
In the uk the advice is along the lines of a glass every now and again is absolutely fine. I probably drink about 5 units ish a week but I do avoid alcohol on mtx taking day. My liver function test has always been fine too.
Probably not worth emigrating for though.
Ask your doctor. It's your doctor's job to know these thins.
I'd just worry for something like this that the response may be individual. Your doctor might know from your last blood test if your liver is acting stressed or not.
Happy St. Patrick’s Day!
I haven’t asked my doc and I know he didn’t mention anything when prescribing the MTX. I guess he assumed I already knew the rules? I, for the most part, abstain. It’s just easier for me to not worry which day of the week it is possibly, maybe ok if I have one measly glass of wine or one very lonely beer. 
I completely broke the rules today. Took my mtx last night and had at least 9 drinks if not more. Im a complete mess and have been for a while this is the first time I had anything to drink since starting mtx. Been crying all.day/night and will have a liver juice first thing in the morning. I feel like a piece of crap for having such a bad time.
Andrew my doctor has suggested that its not a good idea to drink regularly, but seems to think one or 2 while on holiday is ok. But I don't know what this means as it's so generalised. As you say its individual. I was interested in what other peoples experiences were. My liver tests are always fine.
I have since done lots of reading on this. There have been no controlled studies conducted on this issue, hence the array of different responses. Lets hope they study it soon so we know a real answer!
To be honest, I think the main problem is that we are all so different our bodies react differently to different substances.
My liver bloods have always been fine on MTX, and yes, I do have the odd glass of wine or beer (up to, maybe 9 units a month). Trouble is, liver damage doesn't occur over night, its accumulative so its anyone's guess how you personally maybe affected by MTX and alcohol..............if you want to be certain you are doing the best for your liver, don't drink. But it seems quite a few of us here think "a little of what you fancy does you good" ..........Are we just risk takers?...... Probably !! :)
I generally drink once a week on Saturdays and take Mtx on Tuesdays and sulphasalazine every day. It will been a year for me at the end of March and so far all liver tests are fine. I am generally a scotch drinker.
And I keep on asking my doctor about alcohol almost everytime I go to see him, and he says that he will tell me when I should stop alcohol.
So, I guess, my doctor is keeping an eye on indicators that will led him to decide whether I should keep drinking or stop. Just FYI, I am in India.
I am drinking too much. I drink beer, am drinking 6+ beer 3 or more times per week. I am self-medicating - I'm working through some ptsd issues. I'm also dealing with depression ( I take appropriate medication). The alcohol just kills my energy the day after, and energy is limited enough with this disease. The beer also seems to make my anxiety worse the next day.
I take Mtx 17.5 mg/week, Meloxicam 7.5 mg x 2/day, Folic Acid 4 days/week and Misoprostol. I'm worried about what I may be doing to my body.
I'm an all or nothing drinker - moderation isn't really an option for me. I had 15 years sober until about 2 years ago, and started again. It was very mild at first, but now it's out of hand. I know I have to stop completely.
I've been to AA but it's really not a good fit for me anymore. I am looking for any suggestion that might be helpful, but no preaching please - I know that I may be harming my body, I know I'm drinking far too much. I'm looking for tips or support ... I know I simply have to find a way to stop.
Thanks
Forgot to mention that I also take Tramadol (Durela) sparingly. I take 200mg once daily usually on the days I work, so 3-4 days/week.
I am sorry you are experiencing this JW. AA is the only thing I know that works. Have you looked in your area for alternate therapies? I know some therapists specialize in substance abuse. I am glad you recognize it is self medicating and that it actually makes you feel worse after the initial high. I would never preach at you for it. We all have something: I smoke. I will keep you in my thoughts and prayers.
Michael,
Thank you for your suggestion, your kindness and understanding. It means A LOT :)
Take good care.
Hi JW, can I just say that recognising you have a problem with any substance is a big big step…alot of people will justify what they use, or measure it against someone who uses more, to minimize what they in fact do.
Thinking of you, and hope you find the strength you need x