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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does taking Methotrexate and a folic acid supplement together cause green bowel movements?

I have just started taking methotrexate along with folic acid within the last week for psoriasis. Suddenly, I noticed that my stools have turned green. VERY GREEN. Is that normal? I’m also worried about other side effects. Also, I read that taking NSAIDS with methotrexate can be fatal. Is that true?
Mon, 11 Jun 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Green stool usually relates to either food or drink consumed or the frequency of bowel movements. In terms of the frequency of bowel movements, bile is normally present in the stool but as the stool passes through the intestines, the bile is modified and changes the stool from green to brown.

If a person passes stool more frequently, then bile does not have the time to undergo these changes and the stool appears green.

In terms of the interaction between medications, NSAIDS can increase the levels of Methotrexate by decreasing its clearance by the kidney. This can cause very high Methotrexate levels in the body in some persons.

I hope this helps.
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