Frequently asked questions

Get the answers you need about treating relapsing MS with Tecfidera® (dimethyl fumarate).

What should I do before I start taking TECFIDERA?

To get started with TECFIDERA, you need one blood draw and you can begin treatment. You can expect your healthcare provider to check your white blood cell count before you take TECFIDERA and occasionally during treatment. Your healthcare provider should also run blood tests to check your liver function before starting TECFIDERA and as necessary during treatment.

How should I take TECFIDERA?

When taking TECFIDERA, it's important to keep the following in mind:

  • Take TECFIDERA exactly as your healthcare provider tells you to take it
  • The recommended starting dose is one 120 mg pill taken by mouth 2 times a day for 7 days
  • The recommended dose after 7 days is one 240 mg pill taken by mouth 2 times a day
  • TECFIDERA can be taken with or without food
  • Swallow TECFIDERA whole. Do not crush, chew, or sprinkle pill contents on food
  • Protect TECFIDERA from light. You can do this by storing the pills in their original container
  • If you take too much TECFIDERA, call your healthcare provider or go to the nearest hospital emergency room right away

Read more about TECFIDERA dosing.

I missed a dose of TECFIDERA. How can I remember to take it?

Taking TECFIDERA exactly as prescribed by your healthcare provider gives you the best chance of getting its full benefits. Recommended dosing for TECFIDERA is one pill taken twice a day. We have several tips that could help you stay on track with treatment.

Can I take TECFIDERA if I'm pregnant?

There isn't enough data on the development risk associated with the use of TECFIDERA in pregnant women, including whether exposure is harmful to the mother or to the development of the fetus. Be sure to speak to your healthcare provider as soon as you learn that you are pregnant or if you're planning to become pregnant.

If you're pregnant while taking TECFIDERA, talk to your healthcare provider about enrolling in the TECFIDERA Pregnancy Registry to monitor your health and the health of your baby.

Does TECFIDERA have serious side effects?

Some serious side effects of TECFIDERA include:

  • allergic reactions
  • PML (a rare brain infection that usually leads to death or severe disability)
  • decreases in your white blood cell count
  • liver problems
  • herpes zoster infections (shingles), including central nervous system infections
  • other serious infections

What are the most common side effects of TECFIDERA?

Flushing and stomach problems are the most common side effects of TECFIDERA. Flushing symptoms are usually described as redness, itching, or rash. Stomach symptoms include nausea, vomiting, diarrhea, stomach pain, or indigestion. 

Learn more about the most common side effects of TECFIDERA and how they tended to decrease over time in clinical trials.

What should I do if I experience common side effects?

If you're experiencing any of the common side effects of TECFIDERA, talk to your healthcare provider about trying the tips below: 

  • Tips for flushing

Taking a non-coated aspirin (up to 325 mg) half an hour before taking TECFIDERA may help with flushing. Another tip that may help is taking TECFIDERA after a meal.

  • Tips for stomach problems

Taking TECFIDERA with food may help with stomach problems.* High-fat foods like peanut butter, cheese, or yogurt may be particularly helpful. If you decide to take TECFIDERA with food, it should be taken after you eat. Visit the USDA website for more about how fats fit into a healthy diet.

You can also ask your healthcare provider or pharmacist about over-the-counter medicines, like antacids, since that may help.* Read more about tips for handling the most common side effects.


*In a small 12-week study, people recorded their experience of managing stomach problems while on TECFIDERA. They found that taking it with food or over-the-counter medications could help.

How long do common side effects last?

In clinical trials, common side effects tended to happen earlier in treatment and usually decreased over time. Keep in mind that everyone is different and may react differently to the same medication.

What’s PML?

PML is a rare brain infection that usually leads to death or severe disability over a period of weeks or months. Tell your healthcare provider right away if you get any of these symptoms of PML:

  • weakness on one side of the body that gets worse
  • clumsiness in your arms or legs
  • vision problems
  • changes in thinking and memory
  • confusion
  • personality changes

How effective is TECFIDERA?

How can I tell if TECFIDERA is working?

Talking to your healthcare provider about the results of your MRI could help with the management of your relapsing multiple sclerosis (MS). Lesions revealed on an MRI scan may help your healthcare provider determine how well your treatment is working.

How does TECFIDERA work?

It is unknown exactly how TECFIDERA works in the body, but researchers have discovered what it does in the cells.

  • Oxidative Stress

During inflammation, the body produces toxins that can cause oxidative stress on the cells. When this stress builds up, it can damage or even destroy healthy cells in different parts of the body, including the central nervous system (CNS). 

  • Nrf2 Pathway

One way the body reacts to oxidative stress is through a pathway called Nrf2, short for nuclear factor (erythroid-derived 2)-like 2. This pathway is an important part of a complex communication system involved in the body's response to oxidative stress. 

  • Dimethyl Fumarate

Researchers have learned that dimethyl fumarate leads to activation of the Nrf2 pathway in our cells. Much about how TECFIDERA works in the body remains unknown, but talking with your doctor can help you learn more about your treatment options.

What kinds of events does TECFIDERA offer, and how can I sign up?

TECFIDERA offers free educational webinars and live events throughout the year. Some of the live events may even take place in your area! We encourage you to bring your care partner or friend along with you to any TECFIDERA event. It's a nice way for them to learn more about relapsing MS while you expand your support network.

To sign up, just go to Find Events, select the TECFIDERA event you’re interested in, and click on “Register.”

Why should I join a TECFIDERA event?

TECFIDERA events are great opportunities to connect with others in your area who are living with relapsing multiple sclerosis (MS). You can learn more about TECFIDERA, hear inspirational stories, and get answers to your questions. Be sure to talk to your healthcare provider, who is always your primary resource when it comes to your relapsing MS and your treatment.

What kind of support does TECFIDERA offer?

If you’re living with relapsing multiple sclerosis (MS), know that you’re not alone. Biogen Support Services is here to help along the way. As soon as you’re prescribed brand-name TECFIDERA, we can provide help with:

  • Financial assistance
  • Navigating insurance
  • Learning more about your therapy

Remember, your healthcare team is always your best source of information.

What can I do if my insurance doesn't cover TECFIDERA?

At Biogen, our goal is for everyone to get the support they need so they can afford their brand-name TECFIDERA. Our Support Coordinators can work with you to understand your insurance coverage and medication cost and explore financial assistance options for your treatment. Check out our financial and insurance support page for more information.

How can I find out if I’m eligible for the Biogen Copay Program ?

Biogen Support Coordinators can help identify potential options for financial assistance with your relapsing MS medication if you are:

  • Commercially insured
  • Government insured
  • Uninsured or underinsured

Call Biogen Support Services at 1-800-456-2255 to see if you’re eligible.

Depending on your income or, in some cases, if your medication is obtained from an out-of-network provider, there may be an annual cap that limits the amount of assistance that you can receive over one year. 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 state of Massachusetts.

How can a Nurse Educator help me?

Nurse Educators are registered nurses, and many are MS-certified.
They’re available to and can:

  • Answer questions or provide information 24/7 related to your relapsing MS and brand-name TECFIDERA
  • Provide ongoing phone support on how to take your medication and managing common side effects
  • Review instructions from your healthcare provider and connect you with available resources

Biogen Support Services offers free access to Nurse Educators 24/7. To reach one, call 1-800-456-2255. Support is also available in Spanish.

Explore topics:

TAKING TECFIDERA

What should I do before I start taking TECFIDERA?

To get started with TECFIDERA, you need one blood draw and you can begin treatment. You can expect your healthcare provider to check your white blood cell count before you take TECFIDERA and occasionally during treatment. Your healthcare provider should also run blood tests to check your liver function before starting TECFIDERA and as necessary during treatment.

How should I take TECFIDERA?

When taking TECFIDERA, it's important to keep the following in mind:

  • Take TECFIDERA exactly as your healthcare provider tells you to take it
  • The recommended starting dose is one 120 mg pill taken by mouth 2 times a day for 7 days
  • The recommended dose after 7 days is one 240 mg pill taken by mouth 2 times a day
  • TECFIDERA can be taken with or without food
  • Swallow TECFIDERA whole. Do not crush, chew, or sprinkle pill contents on food
  • Protect TECFIDERA from light. You can do this by storing the pills in their original container
  • If you take too much TECFIDERA, call your healthcare provider or go to the nearest hospital emergency room right away

Read more about TECFIDERA dosing.

I missed a dose of TECFIDERA. How can I remember to take it?

Taking TECFIDERA exactly as prescribed by your healthcare provider gives you the best chance of getting its full benefits. Recommended dosing for TECFIDERA is one pill taken twice a day. We have several tips that could help you stay on track with treatment.

Can I take TECFIDERA if I'm pregnant?

There isn't enough data on the development risk associated with the use of TECFIDERA in pregnant women, including whether exposure is harmful to the mother or to the development of the fetus. Be sure to speak to your healthcare provider as soon as you learn that you are pregnant or if you're planning to become pregnant.

If you're pregnant while taking TECFIDERA, talk to your healthcare provider about enrolling in the TECFIDERA Pregnancy Registry to monitor your health and the health of your baby.

Side effects

Does TECFIDERA have serious side effects?

Some serious side effects of TECFIDERA include:

  • allergic reactions
  • PML (a rare brain infection that usually leads to death or severe disability)
  • decreases in your white blood cell count
  • liver problems
  • herpes zoster infections (shingles), including central nervous system infections
  • other serious infections

What are the most common side effects of TECFIDERA?

Flushing and stomach problems are the most common side effects of TECFIDERA. Flushing symptoms are usually described as redness, itching, or rash. Stomach symptoms include nausea, vomiting, diarrhea, stomach pain, or indigestion.

Learn more about the most common side effects of TECFIDERA and how they tended to decrease over time in clinical trials.

What should I do if I experience common side effects?

If you're experiencing any of the common side effects of TECFIDERA, talk to your healthcare provider about trying the tips below:

  • Tips for flushing

Taking a non-coated aspirin (up to 325 mg) half an hour before taking TECFIDERA may help with flushing. Another tip that may help is taking TECFIDERA after a meal.

  • Tips for stomach problems

Taking TECFIDERA with food may help with stomach problems.* High-fat foods like peanut butter, cheese, or yogurt may be particularly helpful. If you decide to take TECFIDERA with food, it should be taken after you eat. Visit the USDA website for more about how fats fit into a healthy diet.

You can also ask your healthcare provider or pharmacist about over-the-counter medicines, like antacids, since that may help.* Read more about tips for handling the most common side effects.

*In a small 12-week study, people recorded their experience of managing stomach problems while on TECFIDERA. They found that taking it with food or over-the-counter medications could help.

How long do common side effects last?

In clinical trials, common side effects tended to happen earlier in treatment and usually decreased over time. Keep in mind that everyone is different and may react differently to the same medication.

What’s PML?

PML is a rare brain infection that usually leads to death or severe disability over a period of weeks or months. Tell your healthcare provider right away if you get any of these symptoms of PML:

  • weakness on one side of the body that gets worse
  • clumsiness in your arms or legs
  • vision problems
  • changes in thinking and memory
  • confusion
  • personality changes
Effectiveness

How effective is TECFIDERA?

In clinical studies, TECFIDERA was shown to:

How can I tell if TECFIDERA is working?

Talking to your healthcare provider about the results of your MRI could help with the management of your relapsing multiple sclerosis (MS). Lesions revealed on an MRI scan may help your healthcare provider determine how well your treatment is working.

How does TECFIDERA work?

It is unknown exactly how TECFIDERA works in the body, but researchers have discovered what it does in the cells.

  • Oxidative Stress

During inflammation, the body produces toxins that can cause oxidative stress on the cells. When this stress builds up, it can damage or even destroy healthy cells in different parts of the body, including the central nervous system (CNS).

  • Nrf2 Pathway

One way the body reacts to oxidative stress is through a pathway called Nrf2, short for nuclear factor (erythroid-derived 2)-like 2. This pathway is an important part of a complex communication system involved in the body's response to oxidative stress.

  • Dimethyl Fumarate

Researchers have learned that dimethyl fumarate leads to activation of the Nrf2 pathway in our cells. Much about how TECFIDERA works in the body remains unknown, but talking with your doctor can help you learn more about your treatment options.

TECFIDERA events

What kinds of events does TECFIDERA offer, and how can I sign up?

TECFIDERA offers free educational webinars and live events throughout the year. Some of the live events may even take place in your area! We encourage you to bring your care partner or friend along with you to any TECFIDERA event. It's a nice way for them to learn more about relapsing MS while you expand your support network.

To sign up, just go to Find Events, select the TECFIDERA event you’re interested in, and click on “Register.”

Why should I join a TECFIDERA event?

TECFIDERA events are great opportunities to connect with others in your area who are living with relapsing multiple sclerosis (MS). You can learn more about TECFIDERA, hear inspirational stories, and get answers to your questions. Be sure to talk to your healthcare provider, who is always your primary resource when it comes to your relapsing MS and your treatment.

Finding support

What kind of support does TECFIDERA offer?

If you’re living with relapsing multiple sclerosis (MS), know that you’re not alone. Biogen Support Services is here to help along the way. As soon as you’re prescribed brand-name TECFIDERA, we can provide help with:

  • Financial assistance
  • Navigating insurance
  • Learning more about your therapy

Remember, your healthcare team is always your best source of information.

What can I do if my insurance doesn't cover TECFIDERA?

At Biogen, our goal is for everyone to get the support they need so they can afford their brand-name TECFIDERA. Our Support Coordinators can work with you to understand your insurance coverage and medication cost and explore financial assistance options for your treatment. Check out our financial and insurance support page for more information.

How can I find out if I’m eligible for the Biogen Copay Program?

Biogen Support Coordinators can help identify potential options for financial assistance with your relapsing MS medication if you are:

  • Commercially insured
  • Government insured
  • Uninsured or underinsured

Call Biogen Support Services at 1-800-456-2255 to see if you’re eligible.

Depending on your income or, in some cases, if your medication is obtained from an out-of-network provider, there may be an annual cap that limits the amount of assistance that you can receive over one year. 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 state of Massachusetts.

How can a Nurse Educator help me?

Nurse Educators are registered nurses, and many are MS-certified.
They’re available to and can:

  • Answer questions or provide information 24/7 related to your relapsing MS and brand-name TECFIDERA
  • Provide ongoing phone support on how to take your medication and managing common side effects
  • Review instructions from your healthcare provider and connect you with available resources

Biogen Support Services offers free access to Nurse Educators 24/7. To reach one, call
1-800-456-2255.
Support is also available in Spanish.

TECFIDERA & GENERICS

Are generics available for TECFIDERA?

Yes. When discussing therapies with your healthcare provider, it's important to consider all options. Brand-name TECFIDERA may be worth a conversation.

You may have questions about the cost of TECFIDERA. Thanks to the Biogen Copay Program, eligible patients could pay as little as $0 a month for their TECFIDERA treatment. You'll also have access to a wide array of support services that are only available to people treating with brand-name TECFIDERA or another Biogen therapy. Check out the support offered by Biogen Support Services.

How can I make sure I’m getting brand-name TECFIDERA from my healthcare provider and my specialty pharmacy?

There are 3 simple tips you can follow to make sure you receive brand-name TECFIDERA. It’s important you keep an open dialogue with your healthcare provider and specialty pharmacy to ensure your prescription will be filled as discussed.

If you realize you’re not getting brand-name TECFIDERA, call your healthcare provider and inform them immediately. You can also contact a Biogen Support Coordinator at 1-800-456-2255. They are ready to help make sure you receive brand-name TECFIDERA.

What if I’m switched from TECFIDERA to a generic option by my insurance?

You can reach a Biogen Support Coordinator at 1-800-456-2255. They’ll help you navigate and understand your financial and insurance information. They will also help you access the resources you may need and answer the questions you may have.

Get support today. Call 1-800-456-2255 Monday-Friday from 8:30 AM to 8 PM ET. Hablamos español.

Are generics available for TECFIDERA?

Yes. When discussing therapies with your healthcare provider, it's important to consider all options. Brand-name TECFIDERA may be worth a conversation.

You may have questions about the cost of TECFIDERA. Thanks to the Biogen Copay Program, eligible patients could pay as little as $0 a month for their TECFIDERA treatment. You'll also have access to a wide array of support services that are only available to people treating with brand-name TECFIDERA or another Biogen therapy. Check out the support offered by Biogen Support Services.

How can I make sure I’m getting brand-name TECFIDERA from my healthcare provider and my specialty pharmacy?

There are 3 simple tips you can follow to make sure you receive brand-name TECFIDERA. It’s important you keep an open dialogue with your healthcare provider and specialty pharmacy to ensure your prescription will be filled as discussed.

If you realize you’re not getting brand-name TECFIDERA, call your healthcare provider and inform them immediately. You can also contact a Biogen Support Coordinator at 1-800-456-2255. They are ready to help make sure you receive brand-name TECFIDERA.

What if I’m switched from TECFIDERA to a generic option by my insurance?

You can reach a Biogen Support Coordinator at 1-800-456-2255. They’ll help you navigate and understand your financial and insurance information. They will also help you access the resources you may need and answer the questions you may have.

Get support today. Call 1-800-456-2255 Monday-Friday from 8:30 AM to 8 PM ET. Hablamos español.