Is it safe to take Humira and alcohol together?

Healthline/Medical News Today Mar 29, 2019

Many doctors consider it safe for people to drink alcohol in moderation while taking Humira (adalimumab). However, there is little research into how alcohol and adalimumab interact, so researchers may not yet know the risks.

According to adalimumab's patient information sheets, "There are no particular risks associated with alcohol when you are taking HUMIRA." Adalimumab is an injectable biologic medication that doctors prescribe to treat inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, Crohn's disease, ulcerative colitis, and hidradenitis suppurativa.

People who take adalimumab and drink alcohol should also consider that other medications they may take for chronic conditions can interact with these two substances. In this article, we look at whether it is safe for people to drink alcohol while taking adalimumab, the side effects and risks, and other drug interactions.

Is drinking alcohol safe while taking adalimumab?

Abbvie, the manufacturers of adalimumab, report that there are no immediate concerns that authorities have associated with taking adalimumab and drinking alcohol. However, researchers have conducted few studies on how adalimumab interacts with alcohol. As a result, they do not really know exactly how much alcohol is safe or the specific risks.

Most concerns regarding medicines and the liver relate to the fact the liver breaks down alcohol waste products and also breaks down many medicines. Drinking alcohol and taking certain medicines can place extra demands on the liver, causing liver damage. However, the liver does not break down adalimumab. This means that it is less likely that drinking alcohol and using adalimumab will cause damage compared with other medications, such as acetaminophen.

Learn about the safety and risks of taking acetaminophen with alcohol.

Because of the way adalimumab is broken down in the body, drinking alcohol in moderation is likely to be safe for those who take the medication. According to the Centers for Disease Control and Prevention (CDC), drinking in moderation is having 2 drinks per day for men and 1 drink per day for women. Drinking alcohol to excess can be harmful for many body systems, especially the liver.

Risks of drinking alcohol and taking adalimumab

One of the possible side effects for adalimumab use is liver injury, though this is rare. According to the National Institutes of Health, most adalimumab-related liver injury occurs within a few months of starting to take the drug. While doctors do not know exactly why adalimumab can damage the liver, they believe the medicine could impair immune function and contribute to liver inflammation because of its effects on the immune system. Because the liver breaks down alcohol, doctors believe it is possible that drinking alcohol could increase the risk of this side effect. However, scientists need to do more research.

Those who take adalimumab for the treatment of rheumatoid arthritis may also take the medication methotrexate. Traditionally, doctors encourage a person to limit or avoid alcohol while taking methotrexate due to the risks for elevated liver enzymes and liver damage. According to a study published in the BMJ, those who take methotrexate can typically drink in moderation, or up to 14 units of alcohol a week, without the risk of liver damage. If a person takes a higher dose of methotrexate, alcohol may be more likely to damage the liver. People can speak to their doctor about their personal risks given the medications they take and their medical conditions.

Side effects of adalimumab

Adalimumab is an effective treatment, though, like all prescription medications, it can cause side effects. People can discuss potential side effects with their doctor. People may experience the following mild side effects after taking adalimumab:

  • Injection site reactions, such as a rash, swelling, bruising, or itching
  • Muscle aches
  • Coughing
  • Diarrhea
  • Fatigue
  • Burning sensation when urinating
  • Blood in mucus
  • Shortness of breath
  • Stomach upset
  • Weight loss

If a person experiences these side effects, they can talk to their doctor about whether they should continue taking adalimumab. Examples of the most serious side effects relating to taking adalimumab include:

  • Affected liver function: Certain symptoms, including yellowing of the eyes or skin, right-sided abdominal pain, vomiting, and fatigue, suggest a person is experiencing liver problems
  • Affected nervous system functions: Sometimes, a person may experience numbness and tingling in their extremities, vision changes, and dizziness
  • Allergic reactions: A person can be allergic to adalimumab. Allergic reactions may range from difficulty breathing to swelling of the eyes, lips, and face
  • Blood changes: adalimumab can cause easy bleeding, bruising, or a pale complexion
  • Immune system changes: Sometimes, a person can experience a lupus-like reaction to taking adalimumab. This includes symptoms such as joint pain, rash on the cheeks or arms, chest discomfort, or shortness of breath
  • Increased risks for infections: These include tuberculosis and other opportunistic infections due to viral, bacterial, or fungal illnesses

These are rare and severe side effects that doctors have associated with taking adalimumab.

Other interactions with adalimumab

Adalimumab can interact with a number of medications. A person should always talk to their doctor about prescription medications and supplements they may be taking. Examples of medicines that interact negatively include:

  • Abatacept
  • Cancer treatments, such as doxorubicin, vincristine, and carboplatin
  • Corticosteroids, such as dexamethasone, hydrocortisone, and prednisone
  • Cyclosporine
  • Echinacea
  • Rituximab
  • Tacrolimus
  • Theophyllines
  • Live vaccines, such as adenovirus, influenza nasal, varicella, or yellow fever vaccines
  • Warfarin

Just because a person takes these medicines does not mean they cannot take adalimumab. A doctor can evaluate every medication and how they may interact with each other to determine the best times and dosages of each one.

Outlook

If a person takes other medicines in addition to adalimumab, they can talk to their doctor to ensure these are safe too. With their doctor's approval, they can likely drink alcohol in moderation while taking adalimumab. If a person experiences signs of liver inflammation, such as yellowing skin, nausea, and abdominal pain, they should seek immediate medical attention.

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