Can You Drink Alcohol When Taking Arthritis Drugs?

In general, a person in good health should limit alcohol intake to no more than one drink a day for women, and no more than two drinks per day for men. Whether or not patients with arthritis can have the same liberties, depends on their medication regimen.

Restaurant server pouring white wine into glass
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Alcohol Can Interact With Methotrexate

Methotrexate is the generic name for the brand name drugs Rheumatrex, Trexall, Otrexup, and Rasuvo. Physicians commonly prescribe it to rheumatoid arthritis patients because it can:

  • Reduce swelling
  • Lessen pain
  • Slow down the progress of the disease

Patients on methotrexate should completely abstain from alcohol due to the fact that the combination of drinking plus methotrexate significantly increases your risk of developing liver damage.

I typically permit my patients to have a drink on a special occasion, such as raising a champagne glass at your child's wedding. However, I ask them to limit alcohol consumption to only a few times per year.

Alcohol Can Produce Erroneous Liver Test Results

Drinking alcohol can produce erroneous results because it can alter markers of liver function in the blood. This can lead your physician to prescribe the wrong dosage of medication, which can cause a variety of unintended effects that would depend on your specific case.

Alcohol and NSAIDs

Even drinking alcohol with over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can cause complications.

Patients taking Tylenol (acetaminophen) regularly should be cautious about their alcohol use. For the average healthy adult, the recommended maximum daily dose of acetaminophen is 4,000 milligrams (mg), but in some people, doses close to the 4,000 mg daily limit could still be toxic to the liver. Therefore, it’s safest not to exceed 3,000 mg per day, especially for people with lower body weight. In addition, alcohol causes the liver to convert acetaminophen into more toxic byproducts than if you were to abstain. As a result, it’s important to take the minimal amount of acetaminophen necessary as well as limit alcohol consumption while taking acetaminophen.

Overuse of alcohol with NSAIDs (nonsteroidal anti-inflammatory drugs) can also increase the risk of stomach ulcers. Patients who take ibuprofen (Motrin) or aspirin (Bayer) are usually safe if they drink a small amount of alcohol, according to information from the National Health Service. However, exceeding the recommended dosage of either medication increases the risk of irritating your stomach lining. In combination with NSAIDs, drinking alcohol also increases this risk and may lead to internal stomach bleeding.

If you have liver or kidney problems, do not take aspirin or ibuprofen unless your health care practitioner tells you it is safe to do so.

Alcohol Impacts Other Symptoms

Finally, many patients with arthritis also have fibromyalgia. A disorder associated with widespread musculoskeletal pain and other distressing symptoms, including mood issues, fatigue and memory problems.

Drinking alcohol in the evening may adversely affect the quality of sleep. Poor sleep can increase the symptoms of fibromyalgia such as fatigue, pain, headaches, and depression. It is best for fibromyalgia patients to avoid drinking later in the day if sleep medications are prescribed due to potential interactions.

About Scott J. Zashin, M.D.

Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is the author of "Arthritis Without Pain: The Miracle of Anti-TNF Blockers" and co-author of "Natural Arthritis Treatment."

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  • American College of Rheumatology: Methotrexate
  • National Health Service: Can I Drink Alcohol If I'm Taking Pain Killers