Methotrexate and Alcohol

by on May 14, 2012

Anyone who is taking methotrexate (also known as MTX) should be aware of possible complications if alcohol is also consumed. The liver’s function of removing poisons and toxins from the blood is seriously taxed when taking methotrexate, and the addition of alcohol only serves to add more stress to an organ that the human body cannot live without.

Liver Health

Typically before a prescribing methotrexate, tests are completed to insure the patient has a healthy liver, heart, and lungs. Beginning treatment with these baseline tests in place is important so that future tests can be compared to them, to find out if any damage has been caused by the drug. If any abnormalities or signs of disease are found in the liver the administration of methotrexate may not be recommended. The liver metabolizes methotrexate and later it is excreted in the urine. Any signs of the liver not being able to accomplish this task would be a red flag for the administration of MTX.

Alcohol Tolerance

Methotrexate is prescribed for chronic diseases like rheumatoid arthritis, psoriasis, Crohn’s disease and cancer. This means that the drug may be taken over many months, years or even a lifetime to alleviate the symptoms of the disease. Over this much time the body stores excess methotrexate in the liver, gall bladder, kidneys and skin. Consumption of alcohol will cause added demand on the liver to remove the alcohol from the blood. The liver’s tolerance for alcohol in addition to the MTX depends upon an individual’s overall health, and the nature of the disease being treated.

Warning Signs

Patients usually do not experience pain or symptoms when the liver is compromised. There are no warning signs for cirrhosis or fibrosis. Only blood tests or liver biopsies can detect liver diseases. People taking methotrexate over extended periods will not notice a problem with an occasional alcoholic beverage.  Unfortunately, there are no guidelines or studies that show what limits to place on alcohol consumption. Some doctors allow patients as little as 2 drinks per month; others as much as 2 per week. Some discourage alcohol use entirely.

Avoidance of Alcohol

Alcohol is a depressant. It slows reactions and reduces a person’s attention span. It is also toxic. A person suffering from a chronic illness may be taking other drugs in addition to methotrexate. Many drugs can have serious side effects when combined with alcohol which would be another reason to avoid it. Common sense dictates the elimination of substances that would further exacerbate an over worked liver, especially in someone who already has a debilitating disease.

Ongoing Monitoring and Testing

People taking methotrexate should undergo blood tests every 8 to 12 weeks to monitor liver toxicity. If abnormal results are found, the next step would be to do a liver biopsy. Since alcohol consumption can cause liver damage it could be more difficult to determine the cause of a liver disease and create unnecessary confusion in developing a treatment plan if patients taking methotrexate also consume alcohol.

Several terrible illnesses are treated with methotrexate but alleviating the symptoms of these diseases can also cause toxicity in vital organs. Consuming alcohol can exacerbate the problems.