Methotrexate and alcohol
The active ingredient methotrexate is used to treat chronic rheumatic diseases. Since it is a highly dangerous drug, improper handling of Methotrexate can be harmful to health and the greatest care is required during use. In addition to undesirable effects of Methotrexate such as nausea and vomiting, kidney and liver damage are also included.
The likelihood of liver damage from methotrexate is increased by alcohol consumption and the use of other liver-damaging drugs (e.g. azathioprine, leflunomide). Therefore, alcohol consumption should be avoided altogether. Methotrexate promotes the transformation of liver cells into functionless connective tissue.
Since alcohol intensifies this process, the risk of liver cirrhosis (connective tissue conversion of liver tissue) increases. Moderate alcohol consumption is not recommended either, as there is no reliable evidence of what amount of alcohol can be drunk safely and without the risk of side effects during methotrexate therapy. There are no long-term studies on alcohol consumption during treatment with methotrexate.
The findings to date only allow the recommendation to refrain from alcohol. In principle, it is important that you inform your doctor immediately if you experience side effects or symptoms during methotrexate therapy (whether or not they are related to alcohol consumption). Treatment with Methotrexate should not be started if the person concerned is addicted to alcohol.
When using methotrexate, symptoms such as fatigue and dizziness may also occur, which in individual cases may limit the ability to operate machinery or drive a motor vehicle. These central nervous system side effects are intensified when combined with alcohol, so the use of alcohol during methotrexate therapy should be avoided. Methotrexate is an active substance that can attack the liver.
Additional alcohol consumption can also damage the liver. In principle, the consumption of alcohol during methotrexate treatment is not prohibited, the general recommendation is to avoid alcohol. In order to understand why methotrexate can damage the liver, it is necessary to know the metabolism of the drug.
Methotrexate is broken down in the liver and excreted through the kidneys (which is why kidney damage can also occur as a side effect). The largest amount of methotrexate is broken down in the liver and excreted on the first day after taking or injecting the syringe. A smaller amount of methotrexate is first converted into a metabolic product similar to methotrexate and is not excreted until the second day after taking methotrexate. During these 48 hours, absolute abstinence from alcohol is recommended, since after this time no significant amounts of methotrexate or its metabolic product are left in the body. This largely avoids the risk of increased liver damage caused by methotrexate.Some doctrines hold the view that (moderate) consumption of alcohol after these 48 hours after methotrexate administration may be acceptable in exceptional cases, but it should always be discussed with the treating physician.