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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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On Methotrexate For Atopic Eczema, Tests Show High ALT. Cause?

I have been on 15mg/week methotrexate for a year for atopic excema (which I have had since childhood) but my ALT test has come out at 59. I have not drunk any alcohol for two weeks so should this have fallen below the safe limit by now? I have been told to come off methotrexate until my ALT level has fallen and have stopped drinking completely since then.
Fri, 8 Nov 2013
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Gastroenterologist,  's  Response
Hi,
Thanks for posting your query.
Methotrexate over a period of time can damage liver and can case fibrosis. It can cause a raise in the liver enzymes.
During methotrexate treatment, one should abstain from alcohol. Because it increases the risk of methotrexate induced liver injury.
The liver enzymes would not have reached baseline within two weeks.
The ideal thing to do is to get a liver biopsy done and proceed with methotrexate treatment only if the biopsy shows no changes or just grade I and II changes.
I hope that answers your question.
Regards.
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On Methotrexate For Atopic Eczema, Tests Show High ALT. Cause?

Hi, Thanks for posting your query. Methotrexate over a period of time can damage liver and can case fibrosis. It can cause a raise in the liver enzymes. During methotrexate treatment, one should abstain from alcohol. Because it increases the risk of methotrexate induced liver injury. The liver enzymes would not have reached baseline within two weeks. The ideal thing to do is to get a liver biopsy done and proceed with methotrexate treatment only if the biopsy shows no changes or just grade I and II changes. I hope that answers your question. Regards.