Lupus and Alcohol: What You Should Know

Medically Reviewed by Sabrina Felson, MD on March 08, 2024
4 min read

Whether it’s a glass of wine after a busy week of work, a cold beer on a sunny day, or dinner and drinks with friends, alcohol is a desirable part of many people’s lives. But if you have lupus, you may wonder how safe it is to drink these beverages.

While it’s usually OK to drink alcohol in moderation with lupus, there are some things to be aware of. To be cautious, ask your doctor about your specific risks with lupus and alcohol before you pick up your favorite alcoholic refreshment.

The main concerns in terms of lupus and alcohol include:

  • The interactions between your lupus medications and alcohol
  • Alcohol’s effects on your liver
  • The risk of gastrointestinal tract (GI) bleeding

You may be on different drugs for lupus. These might include pain medications or other prescription treatments. It’s crucial that you understand the risks each of your medications have when taken with alcohol.

Medications that you shouldn’t take with alcohol. If you take pain medications as a part of your lupus treatment, check with your doctor to see if it’s OK to drink alcohol. Drinking with certain pain medicines (like opiates) can be fatal. Opiates taken with alcohol can also lead to other life-threatening side effects such as:

  • Slowed breathing or stopped breathing altogether
  • Unconsciousness
  • Lowered pulse or blood pressure
  • Coma

If you’re on lupus drugs that your liver metabolizes, don’t drink alcohol at all. These medications may include but aren’t limited to:

If you drink alcohol with medications like these, you’ll heighten your risk of a liver disease called cirrhosis that can lead to liver failure. This condition is not reversible. If you’re unsure whether your lupus medications are metabolized through your liver, ask your doctor. It’s better to avoid alcohol until you know for sure.

Drugs that may not be as effective after you drink alcohol. Some lupus medications won’t work as well if you drink alcohol with them. Ask your doctor if this is a possibility for the drugs in your treatment plan.

Specifically, medicines that prevent blood clots, like warfarin (Coumadin, Jantoven), will be less effective in your lupus treatment if you drink alcohol while on them.

Medications that could heighten your risk of GI bleeding. Certain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, celecoxib (Celebrex), ibuprofen, and naproxen, as well as prednisone can put you more at risk for GI bleeding. Drinking alcohol also makes this more likely. If you drink while on these medications, you put yourself at a greater risk of a harmful side effect.

Medications that may be OK to drink with. Experts haven’t found any interactions between alcohol and hydroxychloroquine (Plaquenil), a drug you may use in your lupus treatment plan. But you may also take other drugs alongside hydroxychloroquine, like methotrexate. If this is the case, you shouldn’t drink alcohol.

If you’re not sure whether your lupus treatment plan is alcohol-friendly, call your doctor. They’ll be able to tell you what’s best for your body based on the specific lupus drugs you take.

Alcohol may be a big part of your social circle. While you shouldn’t feel ashamed for not drinking, it’s normal to be unsure how to say no to friends or co-workers.

Because of this, you may avoid social gatherings or feel uncomfortable if those around you pressure you to drink. It’s important that you learn ways to communicate with your friends so that you don’t have to miss out on fun events. Here are a few tips for how to decline a drink:

Bring your doctor up in conversation. Share your doctor’s advice with your peers, if you’re comfortable. If you bring the expert’s suggestions in, your friends should get the hint. You can say things like “I can’t drink because of a medication I’m on” or “my doctor doesn’t want me to drink alcohol.” Of course, if you don’t want to share personal information about your condition, you don’t have to. A simple “no, thank you” is enough.

Organize your own event. You may feel that all the outings you’re invited to involve alcohol. If you want to take a break from these sorts of gatherings, plan for other types of fun. Ask your friends to join you for lunch, a coffee date, a movie night, or a day out in the park. There are so many options to select from that don’t involve alcohol. Get creative and stay connected with your peers, without the temptation of a drink.

Enjoy a mocktail. You don’t have to have alcohol to be social. Mocktails can be a great way to feel engaged without harming your body. There are tons of delicious non-alcoholic recipes to try. Plus, mocktails can be a great way to avoid the conversation if you don’t want to explain why you can’t drink alcohol.