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DISEASE-MODIFYING THERAPY
Tecfidera (dimethyl fumarate) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with relapsing forms of multiple sclerosis.
These insights are based on 14,157 comments about Tecfidera from MyMSTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Tecfidera works in a way that is not fully known. It has been found to activate a pathway in cells called Nrf2, which helps the body respond to oxidative stress, or cell damage. This pathway may play a role in how the medicine works in multiple sclerosis.
Doctors prescribe Tecfidera in adults with relapsing forms of multiple sclerosis. The medication is a capsule taken by mouth two times a day. For the first seven days, you take a lower dose. After that, you switch to the regular dose for ongoing treatment.
These insights are based on 14,157 comments about Tecfidera from MyMSTeam members.Members who use Tecfidera often say that practical routines can make the medication easier to manage, especially early on. Across the community, people most often mention taking it with food, watching for side effects, keeping up with blood work, staying consistent with doses, and talking with their neurologist if problems continue.
Take Tecfidera with food to help with stomach issues and flushing.
“Make sure you take it with food, protein, and lots of fluids. I’ve been on it for four months and barely notice any side effects now!”
Give your body time to adjust in the first weeks.
“The first month is a trip. That is when the flushing and digestive issues are the worst. After the first month they pretty much go away but occasionally flushing comes.”
Get blood work when your doctor orders it.
“Just make sure to have the Dr closely monitor your blood work every month to start and pay attention to any side effects.”
Try to stick to a regular dosing routine.
“My first week of taking Tecfidera was a success! I never forgot to take a pill and I remembered to take each one with food.”
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In clinical trials of Tecfidera for relapsing forms of multiple sclerosis in adults, the most common side effects occurred in about 12 percent to 40 percent of people. These side effects were reported more often with Tecfidera than with placebo (an inactive treatment).
Tecfidera can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Biogen, the manufacturer of Tecfidera, offers the Biogen Copay Program. Eligible people with commercial insurance may lower their out-of-pocket costs to as low as $0.
To learn more, visit the Biogen Copay Program or call 800-456-2255.
Before starting Tecfidera, your doctor will check your blood counts, including your lymphocyte count, and do blood tests to check your liver (aminotransferases, alkaline phosphatase, and total bilirubin).
Tell your doctor if you have any allergies to dimethyl fumarate or any ingredients in Tecfidera. Do not take Tecfidera if you have had a serious allergic reaction to dimethyl fumarate or any of its ingredients.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Also let your doctor know if you have had recent infections or have low white blood cell counts.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Tecfidera, talk with your doctor about the risks and benefits.
These answers are fact-checked by our editorial staff.
How effective is Tecfidera?
In two-year studies of people with relapsing-remitting multiple sclerosis, Tecfidera reduced relapses and MRI activity compared with placebo. In one study, the annualized relapse rate (average number of relapses per year) was reduced by 53 percent, and in another study, it was reduced by 44 percent. Tecfidera also reduced new or enlarging brain lesions in both studies.
How often is Tecfidera taken for multiple sclerosis?
The starting dose is 120 milligrams by mouth twice a day for seven days. After that, the regular dose is 240 milligrams twice a day. Talk to your doctor if you’re having trouble tolerating the regular dose.
What side effects are most common with Tecfidera for multiple sclerosis?
The most common side effects include flushing, stomach pain, diarrhea, nausea, vomiting, itching, rash, discoloration, and indigestion. In studies, flushing happened in about 40 percent of people taking Tecfidera, compared with about 6 percent taking placebo. Stomach side effects were more common early in treatment, especially in the first month, and usually got better over time.
Taking Tecfidera with food may help reduce flushing. Taking a nonenteric coated aspirin, up to 325 milligrams, 30 minutes before a dose, may help reduce flushing as well. Check with your doctor before taking aspirin to see if this is a safe option for you.
What tests are needed before and during Tecfidera treatment for multiple sclerosis?
A blood test to check your blood cells, including white blood cells called lymphocytes, is needed before you start this medicine, again after six months, and then every six to 12 months, or as your doctor decides. Liver blood tests should be done before starting treatment and during treatment if needed.
On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.
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