Resource Rheumatoid arthritis and alcohol consumption Managing alcohol intake can be important for those taking certain medications. It is important to know what a unit of alcohol looks like and the risks of drinking too much alcohol. Print At a glance It is important that you are honest with your healthcare team about the amount of alcohol you drink. RA medication affected by alcohol Medicines such as methotrexate and leflunomide can affect your liver. When you drink alcohol, your liver has to work harder to process both the alcohol and medication. Non-steroidal anti-inflammatory drugs (NSAIDs) include medicines such as ibuprofen and diclofenac. NSAIDs can affect the lining of the stomach, and alcohol can worsen this effect. Should I stop drinking? Your healthcare team is unlikely to ask you to stop drinking alcohol altogether if you do not wish to. Many studies found that moderate alcohol intake actually improved some RA symptoms. Higher levels of alcohol consumption can be damaging to your body in many different ways. Alcohol can impact symptoms and treatment in psoriasis or psoriatic arthritis. If you have either of these you should discuss your alcohol intake with your healthcare team. They may recommend that you reduce or stop drinking alcohol. How much alcohol should I be drinking? Your healthcare team can make recommendations about alcohol, based on your individual circumstances. General guidance is to drink well within national guidelines: No more than 14 units per week, spread over 3 or more days. Why are alcohol intake levels important in RA?If you are being asked to reduce the amount of alcohol you drink, it can be beneficial to understand why that is. You will be more motivated to follow guidelines if you know the risks of not following them.When taking some medications, your healthcare team may suggest limiting your alcohol consumption. These medications include methotrexate and leflunomide. This is because these medications and the alcohol can affect your liver. When you drink alcohol, your liver has to work harder to process both the alcohol and medication. This extra strain on your liver can lead to damage, which can stop it from functioning well.Another type of medicine that alcohol intake effects is Non-steroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen and diclofenac. NSAIDs can affect the lining of the stomach, and alcohol can worsen this effect. The NHS state that moderate levels of alcohol are not usually harmful when taking NSAIDs. This level of risk will depend on the amount of alcohol, the dose of NSAID and how long you have been taking it. It is worth discussing your personal level of risk with your healthcare team.Be honest with your teamIt is important that you are honest with your healthcare team about the level of alcohol you consume. This makes it safer for them to prescribe medication and check for side effects. You should also make them aware of ‘one-off’ occassions where you drink more than usual. Blood tests to check liver function may be higher than expected after heavy drinking. If your team are unaware that this may be due to alcohol intake, they could misinterpret the results. This could result in unnecessary changes to your medication.If you drink at a level considered ‘heavy’ (above UK government guidelines) you may need to reduce this. Your GP can help you to find services to support you in reducing or stopping your alcohol intake.Our helpline often receive calls about alcohol consumption and RA. Many people are nervous about bringing this up with us. You may worry that it seems trivial or that people might think you have a problem with alcohol if you mention it. Please don’t think that you can’t speak to your healthcare team or to NRAS about this or that you are alone in doing so. Many people drink alcohol and consider if an enjoyable part of their social life. Your healthcare team will understand this and are not there to judge. They are also there to offer you support if you have concerns about the amount you drink.Should I stop drinking altogether?Your healthcare team is unlikely to ask you to stop drinking alcohol altogether if you do not wish to. Many studies found that moderate alcohol intake actually improved some RA symptoms. Function, pain and fatigue were all seen to be better for moderate drinkers than non drinkers. The word ‘moderate’ is important. Higher levels of alcohol consumption can be damaging to your body in many different ways.Alcohol can impact symptoms and treatment in psoriasis or psoriatic arthritis. If you have either of these you should discuss your alcohol intake with your healthcare team. They may recommend that you reduce or stop drinking alcohol.How much alcohol should I be drinking?Your healthcare team can make recommendations about alcohol, based on your individual circumstances. In RA, the majority of guidance on alcohol intake is for those taking methotrexate.British Society for Rheumatology (BSR) and National Patient Safety Agency (NPSA) offer guidance. They recommend that alcohol intake when taking methotrexate be well within national guidelines. For men and women, this should be no more than 14 units per week. Those units are better spread throughout the week over 3 or more days. Having them in one evening (often referred to as ‘binge drinking’) put more strain on the liver. This is because the liver is dealing with a larger hit of alcohol over a shorter period of time.The image below, from ‘Drinkaware’ gives you a visual representation of 1 unit of alcohol. These figures apply to specific measures and strengths of alcohol, as shown.A study in 2017 looked at alcohol intake in over 11,000 RA patients. They used blood test to check liver function in these patients. Patients who drank less than 14 units of alcohol per week did not show signs of risk associated with the liver. Drinking less than 14 units of alcohol per week is better for anyone’s general health. It is especially important for patients on methotrexate.Top tipsDon’t binge drink: Setting a weekly limit for units of alcohol is good. However, these units are better taken throughout the week, rather than all on one evening. Be honest: Give your healthcare team accurate information on how much you drink. Let them know about one-off occurrences of heavy drinking. Tell friends: Friends who you drink with may not understand why you need to limit alcohol intake. It may help to explain this to them to avoid social pressure. Use a unit calculator: Don’t assume that you know how many units are in ‘a glass of wine’. This depends on the size of glass and percentage of alcoholic content. If you are at home, you may may want to buy a wine thimble measure. You can find an example of a unit calculator here: Alcohol Change unit calculatorFurther reading:NHS information on alcoholDrinkawareOK Rehab08/07/2021 Updated: 09/04/2025 Next review: 09/01/2028
At a glance It is important that you are honest with your healthcare team about the amount of alcohol you drink. RA medication affected by alcohol Medicines such as methotrexate and leflunomide can affect your liver. When you drink alcohol, your liver has to work harder to process both the alcohol and medication. Non-steroidal anti-inflammatory drugs (NSAIDs) include medicines such as ibuprofen and diclofenac. NSAIDs can affect the lining of the stomach, and alcohol can worsen this effect. Should I stop drinking? Your healthcare team is unlikely to ask you to stop drinking alcohol altogether if you do not wish to. Many studies found that moderate alcohol intake actually improved some RA symptoms. Higher levels of alcohol consumption can be damaging to your body in many different ways. Alcohol can impact symptoms and treatment in psoriasis or psoriatic arthritis. If you have either of these you should discuss your alcohol intake with your healthcare team. They may recommend that you reduce or stop drinking alcohol. How much alcohol should I be drinking? Your healthcare team can make recommendations about alcohol, based on your individual circumstances. General guidance is to drink well within national guidelines: No more than 14 units per week, spread over 3 or more days.