Most people enjoy an occasional happy hour with co-workers and friends. But what if you have lupus?

We asked two members of our Medical-Scientific Advisory Council for their help in developing some guidelines. Here’s what they had to say:

1. Meds don’t mix

“When people with lupus drink, the most important considerations are alcohol-medication interactions, effects on the liver, and increased risk of GI (gastrointestinal tract) bleeding,” says Karen H. Costenbader, MD, MPH, Director of the Lupus Program at Brigham and Women’s Hospital and Professor of Medicine at Harvard Medical School. She says that people with lupus especially need to be aware of these alcohol-medication interactions:

• First and foremost, mixing alcohol and pain medicines can be fatal. If you’re taking medications to manage your pain, talk to your doctor or pharmacist about any reactions that may result from drinking alcohol.
• If you are taking methotrexate, leflunomide, mycophenolate mofetil, or other drugs that are metabolized in the liver, you should not drink any alcohol at all, due to increased risk of irreversible cirrhosis (liver scarring and failure).
• Certain drugs may not be as effective if you are drinking alcohol; in particular, anticoagulant medicines such as warfarin (Coumadin®).
• Prednisone and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Motrin®), naproxen (Naprosyn®), and celecoxib (Celebrex®) increase risk of GI bleeding, and so does alcohol, so drinking adds increased risk.

2. Know when to say, “No, thanks.”

“Unfortunately, lupus affects very young women,” says Eliza F. Chakravarty, MD, MS, Arthritis and Clinical Immunology Associate Member, Oklahoma Medical Research Foundation in Oklahoma City, “so I have a lot of very young women patients who say, ‘I don’t go out with my friends because they always pressure me to drink alcohol and I just don’t feel good.’ I tell them, ‘Hey, make me the bad guy. Tell your friends, ‘My doctor says I need to get 10 hours of sleep so I can’t stay out past 10 p.m.’, or ‘my doctor says I can’t drink because of my disease,’ or ‘I can’t drink because of my medicine.’”

3. Offer other options

Chakravarty suggests to her patients that they follow that up with an invitation of their own. “Tell your friends, “I’d still like to go and hang out with you for a while—let’s have lunch or get coffee and catch up,’ or, ‘Hey, can you guys just come over to my house and watch a movie?’ That way, you’re staying engaged socially, but you’re not faced with activities that you physically are just not up to.” 

4. Make mine a mocktail!

And remember: You don’t have to drink to stay social: you can always enjoy a nonalcoholic “mocktail” in a fancy glass. Add a twist, a little paper umbrella, and a few good stories, and see if you aren’t the life of the party! There are plenty of great mocktail recipes online, check out our favorites at AllRecipes.com.