Can you drink alcohol while taking methotrexate?
Most guidance advises that alcohol and methotrexate should be avoided or kept to an absolute minimum because both can affect the liver. Drinking alcohol while on methotrexate increases the risk of liver inflammation and liver damage.
How much alcohol is considered “safe” with methotrexate?
There usually isn’t a universally “safe” amount. Many clinicians recommend no alcohol at all during methotrexate treatment, especially if you:
- take methotrexate at higher doses,
- have liver disease or abnormal liver blood tests,
- drink heavily at baseline,
- also take other medicines that can affect the liver.
What liver risks should you know about?
Methotrexate can raise liver enzymes and, in some people, cause liver injury over time. Alcohol adds to that risk, so doctors often monitor liver function with blood tests during treatment.
When should you avoid alcohol completely?
Avoid alcohol if you have any history of liver problems, abnormal liver tests, hepatitis, heavy alcohol use, or if your prescriber has told you to avoid alcohol due to your risk level.
What if you already drank?
If you drank alcohol once, don’t automatically stop methotrexate without advice, but contact your prescriber for guidance—especially if you drank more than usual or you have symptoms such as unusual fatigue, right-sided upper belly pain, dark urine, or yellowing of the skin/eyes.
Quick practical rule
If you’re taking methotrexate, the safest approach is to avoid alcohol unless your prescriber explicitly says otherwise.
If you tell me your methotrexate dose and how often you take it (and whether you have any liver history or abnormal liver tests), I can help you interpret how strict the alcohol guidance usually is in that situation.