Alcohol and Arthritis Medications

People tend to think that warnings pertain to everyone but themselves. It's hard to think of yourself as needing a warning, or being fallible or mortal. Maybe that's just human nature. Sometimes, we need stern reminders and, unfortunately, tragic events often deliver those reminders. With no reference made to what definitively caused Whitney Houston's death on February 11, 2012, her troubled life and shocking death caused television, radio, and print media to turn their attention to the dangers of mixing prescription drugs and alcohol. Whitney is not the first to provoke the discussion, nor will she be the last.

Every prescription bottle has tiny stickers attached that direct proper use or warn us of dangers. While the stickers or labels may be small, the message they carry is not meant to be missed or disregarded. When is the last time you paid any attention to those little stickers? Check your prescriptions. Depending on the specific medication, you will see something like this:

Caution: Do not use with alcohol or non-prescribed drugs without consulting the prescribing practitioner.

Do not drink alcoholic beverages when taking this medication.

I'd call the warnings mostly clear. Why do I say mostly? Some people still seem confused by how literal these warnings are meant to be. So, let's make it clear, once and for all. People with chronic diseases, such as arthritis, tend to take several different medications. A review of the medications commonly taken by people with arthritis turns up the following information about drinking alcohol while taking the drugs.

NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen, naproxen, Celebrex (celecoxib), and Mobic (meloxicam):
NSAIDs may cause bleeding or ulcers in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs long-term, elderly people, those in poor health, or those who drink three or more alcoholic drinks per day while taking NSAIDs. Simply put, the chance of developing an ulcer or bleeding increases with alcohol use.

Acetaminophen (brand name Tylenol; also used in pain killers such as Vicodin):
There is an increased risk of acute liver failure in patients who take acetaminophen at high doses, long-term, or among those who drink alcohol.

DMARDs (disease-modifying anti-rheumatic drugs), such as methotrexate and Arava (leflunomide):
Patients taking methotrexate are advised to avoid alcohol, including beer, wine and hard liquor, because of the increased risk of liver disease. Some doctors suggest that an occasional, celebratory drink (such as on your birthday or other special occasion) may not be harmful, but only abstinence is 100% guaranteed harmless.

Corticosteroids (such as prednisone):
Corticosteroids can cause stomach bleeding. Use of alcohol while using steroids may increase your risk for stomach bleeding.

People with arthritis also may be prescribed sleep medications, antidepressants, or muscle relaxers. These drugs, in combination with alcohol, can also have serious consequences.

The Bottom Line

Medications used to treat arthritis have risks of their own, primarily involving the stomach, intestines, or liver. Alcohol increases those risks. Discuss the matter with your doctor and your pharmacist to be perfectly clear about why it is not advisable to drink alcohol while taking medications.

_Sources:

_{Ibuprofen. PubMed Health. October 1, 2010.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0000915/}

_{Medication Guide for Nonsteroidal Anti-inflammatory Drugs.
http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088646.pdf}

_{American Family Physician. A Family Physician's Guide to Monitoring Methotrexate. October 2000.
http://www.aafp.org/afp/2000/1001/p1607.html}