It is advised that patients not drink alcohol while on methotrexate, as your liver already has to work hard enough with methotrexate alone. That said, you can ask your doctor if an occasional glass of wine would be ok. Everything in moderation, right? As for going on a biologic, your insurance will probably dictate if this is an option. Most times patients need to fail a less expensive therapy before insurance gives the thumbs up to try a biologic, which is much more expensive. Even then, your doctor might want you to be on methotrexate and a biologic at the same time. Biologics often work better when combined with methotrexate. I know! It's messy getting a good treatment for psoriatic arthritis. As to whether or not to even try a biologic, you need to weigh the side effects versus the benefits. It's a personal decision, but I can say that my son and I have been on many, many biologics and have never had a problem with side effects, but we did both get pretty sick (vomiting, mood swings, fatigue) while on methotrexate. For me, biologics were the way to go. I got my life back! I've been on the same biologic for 2 years and can now move furniture up and down stairs, walk marathons and climb sand dunes. I'm definitely not saying this will be your outcome. Every patient is different, and every medication is different. I'm just trying to show that I was, at times, in a wheelchair prior to biologics, and now I lead a pretty normal life. Also, the side effects with biologics are pretty rare. I understand they are scary, but they are very rare. I hope this eases your mind a little. Feel free to reach out to me directly if you'd like to talk more. Sending hope for bright days ahead! - Jaime