RA, Smoking, and Alcohol
The potential risks smoking and drinking pose to people with rheumatoid arthritis.
Do Alcohol and RA Medications Mix? continued...
Methotrexate, like many other medications, is metabolized by the liver. And that's often where the dangers of drinking and medication mixing come into play.
Arava, which goes by the generic name leflunomide, is a companion drug to methotrexate. Moore says he won't offer his patients either unless they agree to stop drinking completely or at least curtail their use of alcohol.
Some patients also use over-the-counter drugs such as acetaminophen, found in many pain relievers and other medications, to help control their pain. Acetaminophen at doses higher than recommended can also cause liver damage.
Physicians keep an eye on their patients' liver functions through regular blood work that monitors liver enzymes. They can sometimes diagnose liver damage caused by both the medications and alcohol.
RA and Drinking
The bottom line: If you're wondering how much you can drink, talk to your doctor.
"Each rheumatologist is different about where they draw the line in the sand about how much they'll let their patients drink," Ruthberg says.
For his patients to stay on methotrexate, Ruthberg allows them no more than a few drinks per week.
Moore asks his patients to keep their drinking to a minimum. And drug interactions aren't the only reason he suggests this.
Limiting alcohol, he says "is once again in respect to different things like obesity, alcohol issues, and accidents. For patients with RA, they may have problems with falling or less control with their hands. And alcohol may complicate that aspect of RA.
"For the type of practice that I have here at Georgia Heath Sciences University, we are really managing patients with more severe disease, more progressive disease. We’re in the fight of our lives to preserve their joints. To do anything to compromise these medicines, I would really be reluctant to do that."