Methotrexate

[Dan Pearson]

I have had a Psoriasis for about a year now.  It got increasingly worse over the summer and, with the cold weather approaching here in Minnesota, I requested to be put on Methotrexate a few months ago.



I have now been on the medication for almost two months and my skin has improved noticably.  Per my doctors instructions, I have not been drinking alcohol while on the drug.



I will be going to Europe for 2 weeks in November and asked my dermatologist if I could discontinue MTX during that time so that I could drink when I'm there.  He stated that he thought that the progress that we have made so far outweighed the ability to "drink a little beer in Germany" and that he "felt strongly" that I continue taking the Methotrexate and avoid alcohol during my trip.



If I discontinue the drug two weeks prior to drinking alcohol are there possible health issues?  I understand what he is saying but feel that if I choose not to take the drug and risk my skin getting worse temporarily isn't that my choice?  After all, its not like there is any cure for psoriasis, only temporary relief.

[Alan Rockoff, MD]

Dan:



You're both right.  Of course, stopping methotrexate is not the end of the world, but doing so might put a crimp in the relationship with your doctor.  My advice is to be diplomatic: tell him that it means a lot to you to enjoy this trip, even if it means risking a flare of psoriasis.  Ask if he's worried about your liver even if you take time off from the drug.  There's no right or wrong here, but as the Good Book says, a soft answer turneth away wrath.



Either way, have a nice trip.



Best.



Dr. Rockoff