I recently started taking Methotrexate. I have been on it 1 month and only taken the full dose once. (My doctor eased me into taking it.) I have found my inflammation and pain have increased since changing to this but that is for another discussion. I have done well cutting out the alcohol, for the most part, due to the risk of liver damage but have had some moments I didn't do so well. I have found the next day, the inflammation and pain was much worse. I overall just feel bad. I have found it is just not worth it, for me. I would find it difficult to not have any alcohol on a great honeymoon like that but just know the pain an inflammation may be worse the next day. Congratulations!! Very exciting times for you! :)

One glass in 6 months isn't going to ruin your liver.

Having said that, I agree fully with Jnyptn that you will feel it in other ways the next morning - and not in a good way!

There wasn't alcohol allowed at the church where we were married and had the reception, so there was less pressure there. You could have sprite or 7UP in your toast and few would be the wiser.

AND you'll feel like consumating that wedding later on. If you feel you have to imbibe on your honeymoon, save it till the end.

If you've been on Methotrexate since November and your liver results have been OK, I would take your Rheumy's advice. I have been taking the maximum dose of MTX (25mg) for 4 years and after the first few months with liver readings in the normal range, my Rheumy told me I could have a glass or two of wine a week.
I pour half glasses and drink water as well. I haven't had any problem the next day with more pain etc but 2 glasses is all I will drink.
Sounds as though you have a lovely time coming up in Summer. Enjoy!!!
Hugs.

I don't think three or maybe four drinks three events is going to send your liver enzymes over the top. American doctors are so much more strict than the European ones over methotrexate. You weigh how you feel, but it takes much more than a couple events, I believe, to raise the enzymes. Then, raised enzymes doesn't equate permanent damage immediately.
from ra warrior.....
There are not a lot of scientific trials studying alcohol, RA and methotrexate. However, in 2006, a study of 550 RA patients demonstrated Alcohol consumption did not correlate with hepatic (liver) injury The average consumption of alcohol for Rheumatoid Arthritis patients in the study was 5 units per week. (I suppose that units are standard-sized drinks.) The researchers also found that methotrexate-treated Psoriatic Arthritis patients were at greater risk for liver toxicity than Rheumatoid Arthritis patients treated with methotrexate are.
Hidden among the other blockbusters from the American College of Rheumatology (ACR) scientific meeting last October were two reports regarding alcohol and methotrexate. Rheumatoid Arthritis patients use methotrexate more than any other drug. And many of them consume alcohol. So, Im glad someone is looking at this.
One study of almost 900 RAers demonstrated an inverse relationship with alcohol consumption to both incidence and severity of Rheumatoid Arthritis. This confirms something which has been shown previously: Alcohol associates with a lower risk for rheumatoid arthritis. There is no implication of causality. The researchers did conclude that further study is needed.
A second study presented at ACR examined methotrexate-taking RA patients classified as alcohol drinkers and alcohol abstainers.They found no difference in the percentage of drinkers (34%) and abstainers (34%) having at least one abnormal LFT (liver function test) result. The drinkers tended to report less pain. It was concluded that further study is necessary, acknowledging that many RA patients taking methotrexate do continue to drink.

http://rawarrior.com/methotrexate-and-rheumatoid-arthritis-is-alcohol-consumption-safe/

For the record, I drink wine with arava, another no no, and not one liver enzyme has raised. I am thinking, however, it is a BIG inflammatory food...YES I said it lol!!! It causes increased pain, so I'm trying to avoid it. Keep that in mind.
Here's another article from nih
http://www.ncbi.nlm.nih.gov/m/pubmed/18702106/

I wouldn't think one or two drinks would do that much harm if your dr said it was ok...there are also a lot of non alcholic beverages out there that comes in such a fancy bottle-you would think they to be some expensive classy wine :)

I'm on MTX as well, and my rheumy specifically told me that 2-3 drinks a week aren't an issue at all.

There have been two occasions in the last 6 months where I had 4 drinks in one evening, and I did regret it. I'm not sure if my liver just can't handle it like it used to, but I absolutely noticed a difference in my tolerance to alcohol.

But - no significant changes to my enzymes.

I totally understand what you're saying though - the thought of having only 2-3 drinks for a week long all inclusive would be impossible for me to do.

I have my annual cottage week with all my good friends in August, and I'm totally at a loss as to how I'm going to deal with having to limit my alcohol. We never ever were drunk (I'm way passed those days!) but it was 'normal' to have 4 or 5 drinks every day.

I would really suggest that you just limit the amount of booze in your drinks while you're away. If you're having something like a marguaritta, then ask for a half shot instead of a full shot, because then you can have twice as many!

At home if I'm having a cooler, I'll pour half the bottle in a glass and top it up with cranberry juice or something. Can't notice the difference but only having half what I used to.

Thank you all for your advice and well wishes :)

Been so long I forgot what it tastes like. I once enjoyed an old fashioned before dinner, but don't remember that either.

I am on just too many medications to even consider alcohol.

Jane

I agree Jane!

The only alcohol I consume anymore is the tiny cup of communion wine on Sundays.

I figure God isn't going to ruin my liver just because I partake in communion

This is my experience with alcohol. I stopped drinking anything when I was on a high dose of methotrexate, but was told I could have a drink now and then. Then I went to Hawaii, five nights in a row I had one Mai Tai. Two weeks later when I had my liver tests done, my numbers were really high. I can't save up by not havering a drink for months, then have five!
So, yesterday we flew to Washington D. C., when we arrived I ordered a glass of wine. I drank half of the small glass of wine, and am now up with RA pains. My liver has been just fine on the Arava, but I guess I just can't get away with anything!
Congratulations on your upcoming Wedding and Honeymoon! Have some fun and promise yourself you will be good when you get back!
Lynne

i'm only on plaquenil. but, when i drink any alcohol something swells up and hurts until my body completely processes and it's totally gone. obviously, the choice is yours but i do not think you are helping you're situation in any way. BTW, CONGRATULATIONS! Now, were I your husband (i am male) and knew what i do know about RA (which he does not) I'd rather have a partner that didn't sacrifice years of intimacy later on for a two week party now. but that's just me.

One thing I notice about drinking alcohol since starting mtx is I get buzzed off about half a drink. I drank infrequently before starting the meds, so I don't think it's that I lost my tolerance to alcohol. I'd say that if you enjoy a buzzed feeling, spread your drinks throughout your festivities so you can have a light buzz, but also go easy on your liver. Drink a hydrating (non-soda) drink in between alcoholic drinks. Keep in mind your body is less resilient than it once was, so be kind to yourself :) Congratulations and enjoy!

Hello @nickle - congrats on your wedding!

You've received a lot of advice here, so the only reason I'm chiming in is because it looks like I may be the "heaviest" drinker here on mtx. I drink 2-4 beers weekly (I'm a craft beer aficionado and I refuse to give it up) and have for several years. Because I've also been on biologics for years as well, I get monthly blood tests that, among other things, test my liver function. Clean as a whistle - never a problem.

FWIW, I used to have a rheumy who wouldn't "allow" anyone in his practice on mtx to drink, period. In contrast, my current rheumy knows my pattern and sees for himself that it works for me, so he's not concerned. Doctors can have widely varying views on drinking and mtx'ing too.

Also, I've seen no difference in my tolerance level or the way I feel the next day...unless I've been drinking red wine, and in that case, I blame how I feel on the tannins, not the mtx!

Enjoy your honeymoon!