Strategies for Managing Common Side Effects1,2

Empower your patients from the start by setting expectations around flushing and
GI symptoms

Most Common Adverse Events: Flushing and GI events. Please see adverse events for additional information.

Fox E, et al 2016 Study Design: In a multicenter, open-label, single-arm, small 233-patient study, patients self-reported GI symptoms over 12 weeks using an eDiary. In the study, patients who regularly took TECFIDERA with food reported some reduction in severe GI events when compared with patients who did not take food.

Limitations: This was a retrospective, observational, post hoc analysis without randomization or a placebo group, and was not designed to assess the efficacy of symptomatic therapies. MS GI symptoms and regular dosing of TECFIDERA with food or use of alcohol/tobacco were not controlled for. Patient selection may have been biased.


Over-the-Counter Options Fatty Foods


Taking non-enteric coated aspirin (up to 325 mg) 30 minutes before taking TECFIDERA may reduce the incidence or severity of flushing.

Taking TECFIDERA with a meal containing fat may help with flushing.*

GI Events2

Recommended therapies for GI symptoms include antacids, bismuth subsalicylate, acid-secretion blockers, and antidiarrheals.

Taking TECFIDERA with fatty food may help mitigate GI events.*

Dose Adjustment

Temporary dose reductions to 120 mg twice daily may help in managing tolerability for individuals who cannot tolerate the maintenance dose.

  • The 240-mg twice daily dose should be resumed within 4 weeks
    • If the maintenance dose still proves to be a challenge, discontinuation of TECFIDERA should be considered
  • 7-day samples of 120 mg TECFIDERA are available through the TECFIDERA Sample Program to provide temporary dose reductions. Find out more at


*A high-fat, high-calorie meal did not affect the overall exposure to TECFIDERA.

TECFIDERA Nurse Educators can help

After you complete a TECFIDERA Start Form, your patients are enrolled to receive ongoing support. TECFIDERA Nurse Educators reinforce your instructions related to dosing, frequency, and common side-effect mitigation.

First 60 Days
of Treatment
  • Help patients understand how to take TECFIDERA
  • Manage common side effects
  • Instruct patients on resources that can help them stay on track with therapy
Throughout Your
Patients’ Journeys
  • Provide your office with patient updates
  • 24/7 phone support
  • Periodic check-ins with patients

References: 1.
TECFIDERA Prescribing Information, Biogen, Cambridge, MA. 2. Fox E, et al. Int J MS Care. 2016;18(1):9-18.