Many people with lupus notice that drinking alcohol makes them feel unwell, and these unpleasant side effects can linger for days or trigger a flare-up. Drinking alcohol also increases the risk of gastrointestinal (GI) bleeding and liver damage, particularly when mixed with certain medications for systemic lupus erythematosus (SLE).

Drinking alcohol puts additional strain on the kidneys, affecting high blood pressure and the hormones that help control kidney function. For people with lupus nephritis, these negative health effects are even more concerning. Whether you can drink alcohol with lupus depends on how your body reacts, and it may be better for you to avoid alcohol altogether to prevent flare-ups or worsening symptoms.

Here, we’ll look at three factors people living with lupus should consider when deciding if they should drink alcohol. We’ll discuss lupus alcohol intolerance, whether alcohol can make lupus worse, and how drinking affects others living with lupus.

1. Alcohol Can Affect Lupus Symptoms

For most people with lupus, alcohol isn’t necessarily off-limits, but the effects can vary. Some find that drinking in moderation is manageable, while others experience symptoms of lupus flare-ups like hot flashes and skin reactions. Some people with lupus still prefer to drink on special occasions, even if it comes with some unpleasant effects.

A number of MyLupusTeam members have shared how alcohol affects them, with many noting that even a small amount can lead to discomfort.

Feeling Hot After Drinking Alcohol

Many people with lupus experience a sense of overheating or flushing after consuming alcohol.

One member shared, “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.”

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. However, this could be related to lupus alcohol flush: a more intense bodily reaction to alcohol, possibly due to an intolerance. This could also be because one of the effects of alcohol is dilated blood vessels

Symptoms of alcohol intolerance include heart palpitations, nausea, and headaches. It’s important to note that these symptoms are not necessarily direct lupus symptoms but may instead be due to the way the body processes alcohol. Many people without lupus also feel flushed and warm when they drink alcohol.

Lupus and Butterfly Rash

Another frequent concern is whether alcohol triggers a lupus 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.”

This butterfly rash, or malar rash, is a common symptoms of lupus, and alcohol may act as a trigger for some individuals.

Some members believe that this issue is specifically correlated with a glass of wine. One member 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.”

Switching to a different type of alcohol may help avoid some of these reactions, but it’s important to remember that triggers for lupus flare-ups are unique for each person. If you suspect alcohol is making your lupus worse, it might be best to avoid it altogether and opt for nonalcoholic alternatives.

2. Alcohol May Interact With 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 medications 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. For instance, prednisone is often used to manage lupus flare-ups, but combining it with alcohol can raise the risk of GI bleeding and other side effects.

Even nonsteroidal anti-inflammatory drugs (NSAIDs) that you can purchase over the counter, like aspirin, ibuprofen (Motrin), and naproxen (Aleve) can lead to dangerous bleeding when mixed with alcohol.

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

Can You Drink Alcohol if You Have Lupus?

Drinking alcohol with lupus is risky, especially if you are on medications that interact negatively with alcohol. The body’s reaction to alcohol can vary greatly, so it’s best to consult your doctor and be cautious. Alcohol can worsen symptoms and, in some cases, cause serious health issues, such as digestive tract bleeding or liver damage, particularly if you’re taking certain medications.

Can Alcohol Cause an Autoimmune Flare?

Yes, alcohol can trigger autoimmune flare-ups in people with lupus. Drinking alcohol may lead to an increased risk of inflammation, which can make lupus symptoms worse and lead to a lupus flare. It’s important to monitor how your body reacts and seek medical advice if alcohol seems to worsen your lupus. Try to reduce your risk factors for a lupus flare — including drinking — wherever you can.

Can Lupus Affect the Liver?

Lupus can impact the liver for between 25 percent and 60 percent of people during their disease. Lupus hepatitis affects the liver, which is where medications like steroids, NSAIDs, and immunosuppressants are processed. Drinking even small amounts of alcohol can add extra stress to the liver. Over time, this can lead to cirrhosis (scarring of the liver), which can cause serious issues like hepatic encephalopathy (confusion), portal hypertension (high blood pressure in the liver), and digestive system bleeding. Knowing this can help you reduce alcohol consumption to protect your liver.

3. There Is Help For People With Lupus and Alcohol Addiction

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

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 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 many 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. You must be honest with your providers so that they can provide you with the best care.

Your health care providers 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 will help them advise you on your treatment. They may refer you to a counselor, support group, or psychiatrist who can provide tools and education about alcohol use. Some medications and types of therapy may be recommended to increase your chances of remaining alcohol-free.

Resources To Help With Lupus and Alcohol Addiction

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), which is open 24 hours a day, seven days per week. The number is 800-662-HELP (4357). You’ll be connected with someone who can help you find a treatment center and resources near you. This service is free.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 232,000 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.