I don't want to be a hard a-- about this, but....

[Guest guest]

Steve (and anyone else who wants to take MTX and drink),

You're young. I got very sick when I was a bit younger than you are now

(although I probably have had this since I was a teenager). It's easy at 30 to

make sweeping statements like you've made, about not wanting to stop drinking

for the rest of your life. And it's hard to give us something you like,

something that's fun when you've had to give up so many other things because of

being sick. I felt the same way you did when I started on MTX in 1988---22 years

ago! Then I had two liver biopsies. Not fun at all. Then I had a husband and

children. And my priorities changed. I was unwilling to risk liver failure for

a drink because my husband and children were counting on me. And even a small

risk is still a RISK. I had an uncle who died of liver failure at 21. Yes, 21.

He didn't drink, but was on a medication (not MTX, but Thorazine) that can cause

liver failure. And it did. And by the time anyone realized what was going on

it was too late. Even getting regular blood work won't tell you how much of a

working liver you have left. The liver is a funny organ, it will clear out the

toxins from your body until it WON'T. So sometimes you won't get any warning

that your liver is shot until it stops working. And when it stops working, you

can die WITHIN a few days. It isn't alway a slow decline where you become

jaundiced. Sometimes it just stops.

Sure, maybe you'll be okay. Maybe you won't. The risk is your own to take as

long as you are single. But once you have others depending on you? Then it's

time to reassess your priorities.

Is having a drink worth never seeing your friends again, your wife, your

children? A mature person, recognizing his own responsibilities would always

answer NO (unless he is an alcoholic). But it's my guess that you haven't been

sick for very long and you're still dealing with the idea of your life changing

dramatically. And this is just one more thing you don't want to give up. But

you need to look at this in the LONG TERM. Do you want to risk dying next week?

I'm not saying you will, but you COULD. It's easy to look at that NHS article

and think, " Well, it says USUALLY " and so it won't happen. That's a common

response from people who are young,that sense of immortality, the idea that it

" can't happen to me. " But it happened to my uncle. Remember, it's not just the

MTX and alcohol that are hard on your liver. I'm betting that you may take

other meds that are metabolized through your liver. It's the COMBINATION of

meds, alcohol, Stills that the NHS article isn't taking in to account. Did you

realize that 8 Extra Strength Tylenol taken in one day are enough to cause liver

failure by themselves? So you only take 4 in a day. And you take a drink. And

you take MTX. Add it all together and you could end up with liver failure

suddenly.

If drinking is so important to you that the above things don't matter, then you

have a problem. I'm not going to say that you are an alcoholic because I don't

know you. But normal people, when they understand the long-term risk, weigh it

against the benefit (i.e., the " fun of drinking vs death) and come to the

conclusion that it's better to stay away from alcohol. I'm not talking about

giving up a sip of champagne at your own wedding, but I am talking about giving

up a weekly drink. Because that's not an occasional drink. That's a REGULAR

drink. And, as someone who had to give up drinking at 27 because of MTX, I can

tell you that you can have fun WITHOUT alcohol. Honest.

Below is an article about alcohol and MTX.

Can You Drink Alcohol While Taking Methotrexate?

Contributor

By Madison Whitfield

eHow Contributing Writer

Methotrexate is an antifolate drug used to treat autoimmune diseases and cancer.

Methotrexate works by inhibiting the use of folic acid in the body. Methotrexate

can be used to treat a variety of illnesses, such as Chron's disease, ankylosing

spondylitis, psoriasis, psoriatic arthritis, scleroderma, and rheumatoid

arthritis. Methotrexate can be administered orally or by injection. Side effects

of methotrexate include nausea, vomiting, increased bruising risk, anemia, and

in rare cases, hepatitis.

History

Dr. Sydney Farber pioneered methotrexate while testing folic acid effects on

children with leukemia. In the 1940s, Dr. Farber wrote a medical study

illustrating the positive effects of methotrexate on his leukemia patients. In

1953, methotrexate was approved by the FDA as an oncology drug. Today,

methotrexate is mostly used to treat arthritis and some autoimmune diseases.

Considerations

Women who are pregnant or breastfeeding should not take methotrexate.

Methotrexate is sometimes used in conjunction with the drug misoprostol to

terminate ectopic pregnancies. Therefore, it is very dangerous for women who

could be pregnant to take methotrexate. According to the FDA, methotrexate is

listed in Pregnancy Category X, which states that " Studies in animals or humans

have demonstrated fetal abnormalities and/or there is positive evidence of human

fetal risk based on adverse reaction data from investigational or marketing

experience, and the risks involved in use of the drug in pregnant women clearly

outweigh potential benefits. "

Effects

You should not drink alcohol while taking methotrexate. It is stated in the

literature accompanying methotrexate that alcohol is not recommended or

condoned. Some doctors believe that taking methotrexate in conjunction with

alcohol, especially regular alcohol use, is extremely dangerous and can cause

liver damage and cirrhosis. According to Dr. Supren R. Patel in " A Family

Physician's Guide to Monitoring Methotrexate, " even a " safe " alcohol level is

not recommended because there is no basis to decide how much alcohol is a safe

amount. Dr. Patel states that some doctors believe that abstaining from alcohol

completely while taking methotrexate is the only way to ensure a safe and

healthy lifestyle.

Theories/Speculation

On several health message boards, including the forum on steadyhealth.com,

regular methotrexate users report having a few glasses of wine or beer now and

then without bad or unhealthy results. However, these results are reported

unofficially and are only the results of a few individuals, with no long term

alcohol or drug usage information being taken into account.

Warning

Consuming alcohol while taking methotrexate puts you at risk for liver damage

and cirrhosis. Although some patients may be able to get away with having a few

drinks once in a while, it is not safe to assume that your body will react in

the same manner. If you are experiencing any strange side effects from

methotrexate (whether or not you have consumed alcohol), see your doctor

immediately. Always be honest with your doctor about your use of alcohol.