Many people with lupus notice that they don’t feel well after drinking alcohol, and these unpleasant side effects can linger for days or trigger a flare-up. Alcohol consumption also increases the risk of gastrointestinal (GI) bleeding and liver damage, particularly when mixed with certain medications for systemic lupus erythematosus (SLE).

Unfortunately, drinking alcohol puts additional strain on the kidneys by affecting high blood pressure and the hormones that help regulate kidney function. Therefore, people with lupus nephritis are especially vulnerable to the negative health effects of alcohol.

Here are some important points to keep in mind if you choose to drink with lupus and how lupus has affected the drinking habits of others who are living with the condition.

How Alcohol Affects Lupus Symptoms

For most people with lupus, alcohol isn’t necessarily off-limits. Many find that drinking in moderation is manageable or that alcohol doesn’t affect them to the point that they want to stop completely. Some people with lupus still prefer to drink on special occasions, even if it comes with some unpleasant effects.

Some MyLupusTeam members notice how hot they feel when drinking alcohol or how it affects their skin.

Feeling Hot

“I drink a bit during holiday parties, which immediately makes me very hot, exhausted, and achy. Even so, sometimes I just go for it, knowing I’ll be down for the count for at least three days,” shared one member.

Another wrote, “Every time I have a drink, I break out in a sweaty hot flash. My face and my ears, everything turns red.”

Feeling hot or overheated can be a general symptom of lupus, whether or not you’ve consumed alcohol. Flushing or feeling hot after drinking alcohol could be caused by an alcohol intolerance and not directly related to lupus. Heart palpitations, nausea, and a bad headache are also indicators of alcohol intolerance. Continuing to drink if you have an alcohol intolerance can increase your risk for other health problems.

Developing a Butterfly Rash

One member asked, “I was wondering if anyone else gets a flare of your butterfly rash when you drink? I am starting to think they’re related. I don’t drink much, but if I have a drink or two, my cheeks and the skin across my nose get red and hot.”

Butterfly rash, or malar rash, is a facial rash that covers the cheeks and nose. It is called a butterfly rash because it resembles the shape of a butterfly. It is among the more common symptoms of lupus.

This issue seems particularly correlated with a glass of wine for some members, including one who wrote: “Only red wine or wines aged in oak barrels cause this problem for me. Blush wines like white zinfandel or beer don’t bother me.”

Others have noted a delayed response: “I have the same problem, but the rash comes about 24 hours after I drink wine.”

It’s possible that switching to a different type of alcoholic drink will help prevent some negative symptoms. However, not everyone’s triggers for lupus flare-ups are the same. If alcohol consumption puts you on the path to a flare-up, you may feel it’s best to avoid it and stick to mocktails and other nonalcoholic drinks.

Alcohol and Lupus Medications

One of the biggest dangers of drinking alcohol with lupus is the potential for medication interactions, the Lupus Foundation of America cautions. For instance, many people with lupus rely on pain medication to keep their symptoms under control. But some pain medications cannot be mixed with alcohol, and the results can be life-threatening. It’s important to be open with your doctor about your drinking habits and learn whether it’s safe to drink when taking certain pain medications for lupus treatment.

Several medications come with a greater risk of GI bleeding, which further increases with alcohol consumption. If you’re taking prednisone to manage a flare-up, you should avoid alcohol for this reason. Even nonsteroidal anti-inflammatory drugs (NSAIDs) that you can purchase over the counter, like aspirin, ibuprofen (Motrin), and naproxen (Aleve) can cause dangerous bleeds when mixed with alcohol.

In addition, lupus medications that are metabolized by the liver can cause permanent liver damage and cirrhosis when combined with alcohol. Examples include leflunomide (Arava), mycophenolate mofetil (CellCept), and methotrexate. Always follow your health care provider’s medical advice in order to avoid dangerous interactions between lupus drugs and alcohol.

Where To Find Help

Some members of MyLupusTeam are recovering from alcohol addiction and offer encouragement and insight to others on the message boards.

One member shared, “I don’t know how many of you are in recovery, but I am 90 days sober from alcohol, and I’m so proud of myself. Alcohol is just another battle I have learned to fight. I didn’t realize how much I was self-medicating with alcohol before I got diagnosed. Now it all makes sense. To win the battle, you must fight! Slay on, warriors! 🤺🗡️⚔️💜.”

It’s crucial to make healthy choices to improve your quality of life and protect your mental health when coping with a chronic (ongoing) condition like lupus. If you’re struggling to cut back on alcohol despite the negative effects it has on you and your lupus symptoms, you might need help to quit.

Fortunately, there are lots of resources available that can make a significant difference in your relationship with alcohol. You can start by talking to your primary care doctor or rheumatologist about your concerns. Be honest with your providers so that they can provide you with the best care. They may ask detailed questions regarding your alcohol consumption, including what type of alcohol you drink and how many drinks you have per day or week. This is in order to make decisions regarding your treatment. They may refer you to a counselor, support group, or psychiatrist who can provide tools and education about alcohol use. Certain medications and types of therapy may be recommended to increase your chances of staying alcohol-free.

If you’d like confidential help with alcohol, substances, or mental health, you can call the Substance Abuse and Mental Health Services Administration Helpline (SAMHSA) 24 hours a day, seven days per week. The number is 800-662-HELP (4357). You’ll be connected with someone for free who can help you find a treatment center and resources near you.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you made changes to your drinking habits because of lupus? How does alcohol have an impact on your symptoms and daily life? Share your thoughts in the comments below, or start a conversation by posting on your Activities feed.