Frequently Asked Questions

How do patients take TECFIDERA?

TECFIDERA offers twice-daily oral dosing—1 pill in the morning and 1 pill at night. The starting dose (120 mg capsule) is taken twice a day for the first 7 days of treatment. After 7 days, patients are increased to the maintenance dose (240 mg capsule) twice a day.1

  • TECFIDERA can be taken with or without food, but taking TECFIDERA with food may help with flushing
  • TECFIDERA should be swallowed whole and intact
  • TECFIDERA should not be crushed or chewed, and the contents should not be sprinkled on food
  • Temporary dose reductions to 120 mg twice a day may be considered for individuals who do not tolerate the maintenance dose
    • Within 4 weeks, the recommended dose of 240 mg twice a day should be resumed
    • Discontinuation of TECFIDERA should be considered for patients unable to tolerate return to the maintenance dose
How effective is TECFIDERA?

In the DEFINE trial, a 2-year, randomized, double-blind, placebo-controlled study of 1234 patients with relapsing-remitting remitting MS1:

  • TECFIDERA reduced risk and frequency of relapses
  • TECFIDERA delayed the progression of disability
  • TECFIDERA reduced all studied measures of MRI activity

In the CONFIRM trial, a 2-year, multicenter, randomized, double-blind, placebo-controlled study that also included an open-label comparator arm of 1417 patients with relapsing-remitting MS1:

  • TECFIDERA reduced risk and frequency of relapses
  • TECFIDERA reduced all studied measures of MRI activity
  • The reduction in the proportion with disability progression* was not statistically significant

*Disability progression was defined as at least a 1-point increase from EDSS of ≥1, OR at least a 1.5-point increase for patients with baseline EDSS of 0 sustained for 12 weeks.1
DEFINE=Determination of the Efficacy and Safety of Oral Fumarate in Relapsing-Remitting Multiple Sclerosis2; CONFIRM=Comparator and an Oral Fumarate in Relapsing-Remitting Multiple Sclerosis3; EDSS=Expanded Disability Status Scale.

What should I know about the safety of TECFIDERA?
  • TECFIDERA is contraindicated in patients with known hypersensitivity to dimethyl fumarate or any of its excipients1
  • TECFIDERA carries the following Warnings and Precautions: Anaphylaxis and Angioedema, PML (Progressive Multifocal Leukoencephalopathy), Herpes Zoster and Other Serious Opportunistic Infections, Lymphopenia, Liver Injury, and Flushing1
  • The most common adverse reactions (incidence ≥10%, and ≥2% more than placebo) were flushing, abdominal pain, diarrhea, and nausea1
  • For more information, please view the full Prescribing Information
Are there monitoring requirements for TECFIDERA?
  • Before initiating treatment with TECFIDERA:
    • A CBC, including lymphocyte count, should be obtained as a baseline1
    • Obtain liver tests (serum aminotransferase, alkaline phosphatase, and total bilirubin levels)1
  • During treatment with TECFIDERA:
    • A CBC, including lymphocyte count, should be obtained after 6 months of treatment, every 6 to 12 months thereafter, and as clinically indicated1
    • Liver tests should be obtained per clinical judgment1

CBC=complete blood count.

How can patients get started on TECFIDERA?

If you determine TECFIDERA is right for your patient, remember to specify your state's required "Dispense as Written" language in the prescriber signature of the Start Form. When the Start Form is complete, fax it to Biogen Support Services at 1-855-474-3067. It will be sent to a specialty pharmacy that is compatible with your patient's insurance coverage. The specialty pharmacy will work with your patient's insurance company or, if necessary, find alternative funding sources to get your patients on TECFIDERA as quickly as possible. The prescription can then be shipped directly to your patient's home.


Remind your patients that Biogen Case Managers are available to assist with any questions or concerns. Patients can call 1-800-456-2255, Monday through Friday from 8:30 AM until 8:00 PM ET.

What financial assistance options are available to help patients pay for TECFIDERA?

Biogen can provide assistance once your patients are prescribed TECFIDERA. Biogen Support Services provides financial and insurance assistance options, including the Biogen Copay Program, which may lower medication cost for eligible patients with commercial insurance.*


*Effective January 1, 2021, there is an annual cap on the amount of assistance that patients can receive over a one year period. Federal and state laws and other factors may prevent or otherwise restrict eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll. You are eligible to enroll in the Biogen Copay Program for as long as it is offered and you are treated with a Biogen relapsing MS medication. The Biogen Copay Program is no longer available for TECFIDERA patients in the states of Massachusetts and California.

What tools are available to help patients learn more?

Your patients have full access to Biogen Support Services, including Biogen Case Managers and Nurse Educators. Biogen Case Managers will reach out to your patients after they are prescribed TECFIDERA and help educate them on financial assistance options. Nurse Educators are available to help your patients understand what to expect during treatment and provide additional resources.