Risks of Consuming Alcohol With Humira

Humira (adalimumab) is an injection used by millions of people to manage a variety of inflammatory health conditions. 

You may wonder whether it is safe to consume alcohol while using Humira. The answer is complicated because there haven’t been enough studies done. However, lacking clinical evidence does not mean it's safe.

This article will discuss the potential effects of consuming alcohol with Humira.

What Is Humira?

Humira is the brand name for one of several biologic anti-inflammatory medications that block the action of tumor necrosis factor-alpha (TNF-α). TNF-α is a protein in the immune system. Under normal conditions, it can protect the body from infection and even destroy some tumor cells. However, different types of TNF can also cause inflammation.

Humira is approved by the FDA for the treatment of the following autoimmune disorders (disorders caused by the immune system mistakenly attacking healthy body cells):

• Rheumatoid arthritis
• Polyarticular juvenile idiopathic arthritis
• Psoriatic arthritis
• Ankylosing spondylitis
• Crohn's disease
• Ulcerative colitis
• Hidradenitis suppurativa
• Severe chronic plaque psoriasis
• Several inflammatory eye conditions, such as uveitis

In all these conditions, abnormal inflammation of tissues involves the actions of TNF-α. Adalimumab binds to and neutralizes TNF-α, significantly reducing inflammation and damage. However, because TNF-α is part of the immune system, this comes with an increased risk for infection.

Humira is administered as a subcutaneous injection. That means a needle is used to inject medicine into the tissue between the skin and muscle.

Side Effects

People using Humira may experience side effects and adverse reactions. These may include:

• Redness and swelling at the injection site
• Itching
• Rashes
• Easy bruising
• Upper respiratory infections and sinus infections
• Headaches
• Nausea
• Pain at the injection site

Because Humira suppresses TNF-α, there is a possibility it may reactivate infections, such as tuberculosis, or make it harder to fight new infections. Some infections might be life-threatening. 

There have been reports of rare adverse events when using Humira, including fatal blood disorders, an increased risk for certain cancers, liver injuries, central nervous system disorders, and cardiac failure. Anaphylaxis and serious allergic reactions are rare but possible.

Consuming Alcohol With Humira and Liver Injury Risk

The research on the safety of Humira and alcohol in combination is limited. However, this does not mean the combination is safe. There's a higher risk of liver injury for both TNF inhibitor medications and alcohol separately.

Autoimmune disorders Humira treats can negatively impact the liver too. Additional medications used to treat and manage pain associated with autoimmune conditions can also cause organ damage.

Many patients who take Humira are also using methotrexate to treat their condition (for example, rheumatoid arthritis). Healthcare providers typically recommend that people taking methotrexate limit or avoid alcohol consumption even in the absence of liver disease, as summarized in a 2010 report in the medical journal Clinical and Experimental Rheumatology.

Additionally, some other TNF inhibitors may not work as effectively when taken with alcohol, or they may be released into the system in higher doses. Either case may lead to severe complications.

Does Humira Cause Liver Damage?

The use of TNF-α inhibitor medications is associated with drug-induced liver injury (DILI), also known as toxic hepatitis. Humira's active ingredient, adalimumab, is considered to be less of a concern for this type of liver injury compared to other TNF-α inhibitors—DILI is rare in people who take Humira. However, it still adds liver injury risk—and adding alcohol to the mix further increases that risk.

People with DILI have high liver enzyme levels. Their liver may get larger and they may experience many digestive and whole-body symptoms, including the following:

• Abdominal tenderness
• Dark urine
• White or clay-colored stool
• Fever
• Rash
• Diarrhea
• Headache

In most cases, DILI gets better after you stop taking the medication that caused it. Rarely, it can lead to liver failure.

Summary

The Humira injection helps with inflammation in some autoimmune disorders such as rheumatoid arthritis and Crohn's disease. It works by blocking the action of TNF-α, a protein in the immune system.

There isn't much research on alcohol and Humira specifically, but it's been shown that other TNF-blocking medications, as well as autoimmune disorders themselves, can damage the liver. Consuming alcohol while using Humira can further increase the risk of liver damage.