Generic name: dimethyl fumarate
Drug class: Selective immunosuppressants
Medically reviewed by A Ras MD.
What is Tecfidera?
Tecfidera is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. It is not known if Tecfidera is safe and effective in children under 18 years of age.
TECFIDERA contains dimethyl fumarate which is also known by its chemical name, dimethyl (E) butenedioate, (C6H8O4). It has the following structure:
Dimethyl fumarate is a white to off-white powder that is highly soluble in water with a molecular mass of 144.13.
TECFIDERA is provided as hard gelatin delayed-release capsules for oral administration, containing 120 mg or 240 mg of dimethyl fumarate consisting of the following inactive ingredients: microcrystalline cellulose, silicified microcrystalline cellulose, croscarmellose sodium, talc, silica colloidal silicon dioxide, magnesium stearate, triethyl citrate, methacrylic acid copolymer – Type A, methacrylic acid copolymer dispersion, simethicone (30% emulsion), sodium lauryl sulphate, and polysorbate 80. The capsule shell, printed with black ink, contains the following inactive ingredients: gelatin, titanium dioxide, FD&C blue 1; brilliant blue FCF, yellow iron oxide and black iron oxide.
Mechanism of Action
The mechanism by which dimethyl fumarate (DMF) exerts its therapeutic effect in multiple sclerosis is unknown. DMF and the metabolite, monomethyl fumarate (MMF), have been shown to activate the Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway in vitro and in vivo in animals and humans. The Nrf2 pathway is involved in the cellular response to oxidative stress. MMF has been identified as a nicotinic acid receptor agonist in vitro.
Who should not take Tecfidera?
- Do not use Tecfidera if you have had an allergic reaction (such as welts, hives, swelling of the face, lips, mouth or tongue, or difficulty breathing) to Tecfidera or any of its ingredients. See below for a complete list of ingredients.
What should I tell my healthcare provider before taking Tecfidera?
Before taking and while you take Tecfidera, tell your doctor if you have or have had:
- low white blood cell counts or an infection
- any other medical conditions
Tell your doctor if you are:
- pregnant or plan to become pregnant. It is not known if Tecfidera will harm your unborn baby.
- If you become pregnant while taking Tecfidera, talk to your doctor about enrolling in the Tecfidera Pregnancy Registry. You can enroll in this registry by calling 1-866-810-1462 or visiting www.Tecfiderapregnancyregistry.com. The purpose of this registry is to monitor the health of you and your baby.
- breastfeeding or plan to breastfeed. It is not known if Tecfidera passes into your breast milk. You and your doctor should decide if you will take Tecfidera or breastfeed.taking prescription or over-the-counter medicines, vitamins, or herbal supplements
How should I take Tecfidera?
- Take Tecfidera exactly as your doctor tells you to take it
- The recommended starting dose is one 120 mg capsule taken by mouth 2 times a day for 7 days
- The recommended dose after 7 days is one 240 mg capsule taken by mouth 2 times a day
- Tecfidera can be taken with or without food
- Swallow Tecfidera whole. Do not crush, chew, or sprinkle capsule contents on food.
- Protect Tecfidera from light. You can do this by storing the capsules in their original container.
- If you take too much Tecfidera, call your doctor or go to the nearest hospital emergency room right away.
What are the possible side effects of Tecfidera?
Tecfidera may cause serious side effects including:
- allergic reaction (such as welts, hives, swelling of the face, lips, mouth or tongue, or difficulty breathing)
- PML a rare brain infection that usually leads to death or severe disability
- decreases in your white blood cell count Your doctor should do a blood test before you start treatment with Tecfidera and while on therapy.
- liver problems. Your doctor should do blood tests to check your liver function before you start taking Tecfidera and during treatment if needed. Tell your doctor right away if you get any of these symptoms of a liver problem during treatment.
- severe tiredness
- loss of appetite
- pain on the right side of your stomach
- have dark or brown (tea color) urine
- yellowing of your skin or the white part of your eyes
- herpes zoster infections (shingles), including central nervous system infections
- other serious infections
The most common side effects of Tecfidera include:
- flushing, redness, itching, or rash
- nausea, vomiting, diarrhea, stomach pain, or indigestion
- Flushing and stomach problems are the most common reactions, especially at the start of therapy, and may decrease over time. Taking Tecfidera with food may help reduce flushing.
Call your doctor if you have any of these symptoms and they bother you or do not go away. Ask your doctor if taking aspirin before taking Tecfidera may reduce flushing.
These are not all the possible side effects of Tecfidera. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
General information about the safe and effective use of Tecfidera
- Medicines are sometimes prescribed for purposes other than those listed in this Patient Information. Do not use Tecfidera for a condition for which it was not prescribed. Do not give Tecfidera to other people, even if they have the same symptoms that you have. It may harm them.
- If you would like more information, talk to your doctor or pharmacist. You can ask your doctor or pharmacist for information about Tecfidera that is written for healthcare professionals.
How should I store Tecfidera?
Store at 15°C to 30°C (59 to 86°F). Protect the capsules from light. Store in original container.
Keep out of reach of children.
What are the ingredients in Tecfidera?
Active ingredient: dimethyl fumarate
Inactive ingredients: microcrystalline cellulose, silicified microcrystalline cellulose, croscarmellose sodium, talc, silica colloidal silicon dioxide, magnesium stearate, triethyl citrate, methacrylic acid copolymer – Type A, methacrylic acid copolymer dispersion, simethicone (30% emulsion), sodium lauryl sulphate, and polysorbate 80.
Capsule Shell: gelatin, titanium dioxide, FD&C blue 1; brilliant blue FCF, yellow iron oxide and black iron oxide.
Principal Display Panel – 240 mg Capsules: Box Label
- NDC 64406-006-02
- 60 capsules
- (dimethyl fumarate)
- delayed-release capsules
- 240 mg
- Dispense in original Package.
- Swallow capsule whole.
- Rx only
SRC: NLM .