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Is Alcohol Forbidden When Taking Arthritis Drugs?

Doctor Offers General Advice


Updated May 23, 2014

Question: Doctor's Advice About Drinking Alcohol When Taking Arthritis Drugs

Is alcohol to be avoided by all arthritis patients or does alcohol only need to be avoided if the patient is taking specific medications? What negative effects can drinking alcohol have on arthritis patients? We asked rheumatologist, Scott J. Zashin, M.D.


How Much Alcohol Is Recommended?

In general, it is recommended that all of us limit our alcohol intake to no more than 2 drinks per day. Whether or not patients with arthritis can have the same liberties depend on their medication.

Alcohol Can Interact With Medications

Patients on methotrexate should completely abstain from alcohol due to the fact that the combination of drinking plus methotrexate increase the risk of developing liver damage. I typically permit my patients to have a drink on a special occasion but to limit it to only a few times per year. In addition, alcohol can elevate the liver function tests in the blood which may affect the dose of medication prescribed.

Patients taking tylenol (acetaminophen) regularly should also be cautious about their alcohol use and I recommend no alcohol in patients taking more than 2500 mg per day. Overuse of alcohol with NSAIDs (nonsteroidal anti-inflammatory drugs) can increase the risk of stomach ulcers.

Alcohol Impacts Other Symptoms

Finally, many patients with arthritis also have fibromyalgia. Drinking alcohol in the evening may adversely affect the quality of sleep, increasing symptoms of fibromyalgia such as fatigue and pain. It is best to avoid drinking later in the day if sleep medications are prescribed due to potential interactions.

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 author of Arthritis Without Pain - The Miracle of Anti-TNF Blockers and co-author of Natural Arthritis Treatment.

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