Higher dosage tecfidera?

Festive greetings to all fellow MSers,

As ever coming back to the fountain of knowledge for thoughts, comments and advice re tecfidera. Im just coming to the end of my first week on the low dosage and about to start the higher dose…but having read the posts on here most people have side effects really kick in when on the higher 240 dose? I have from my MS nurse the up to date tactics to manage them …take tablet on a full stomach, aspirin for flushes etc.

So far the flush has been the main side effect but looking for advice , comments on any digestive issues that might occur and finally as we’re coming up to New Year … where does alcohol fit into this complicated picture?

Await in anticipation and thanks for any replies


I don’t know, but as it’s New Year, why not stay on the lower dose for another week :slight_smile:

Hi Meganruth,

The problem is that the lower dose comes in smaller dosage capsules. So it’s not so easy (you can’t just cut them in half unfortunately).

What you could do is take just one of the higher dose for a week rather than one morning and one evening. But you’re not going to be able to get extra half doses easily at this time of year. It’s worth a try though. Phone Alcura and see if they’ll do it. And you won’t even be able to do that before Tuesday. They’ll probably need an amended prescription though and I don’t know if that would be achievable. It will depend on what day you’re due to change up to the higher dose.


hi meganruth

i found out the hard way that eating before taking the tec isn’t enough, have something else after it.

sort of trap it between layers of food.

i have since heard of an ms nurse advising her tec patients to take it halfway through a meal.

have some omeprazole on standby in case you get indigestion.

i find it helps quell the nausea although you may not get nausea (it’s just me, always was a sickly child!).

ideally we’d get extra packs of 100mg tabs.

maybe they’ll learn from those of us who take it, after all it’s a relatively new drug to the nurses as well as to us.

give it a fair try - it’s good to know that we have a powerful weapon to throw at ms.

carole x

When I first started they gave me 4 weeks of the lower dose before going onto the higher one.I take mine one with breakfast and one with evening meal.I have not felt sick at all and the only side effect is flushing but this has settled a bit now and I do not get them as often,but if this is the only side effect then I can live with that.Good luck.


the conventional strategy was to get you started on the 120mg for a week and then go for it full throttle. if side effects came on, then they were to be tolerated. this, was unfortunate.

luckily for me, i was provided with 120mg in quantities that lasted many weeks. I was therefore able to employ the following dosage:

1 cap daily during week one

2 caps daily during week two

3 caps daily during week three (2 as dose one, 1 as dose two)

full dose of 4 caps daily come week four

after a week or two of this, i confidently swapped the 120mg for the 240mg.

if at any point during the initial four weeks things felt ‘a bit squirrely’, i could take one fewer pill for the week (ie. take a momentary ‘step back’). this never occurred, although a sense of the itchiness (aka flushing) struck during week 3 and so for a couple days, i took one cap every four hours… it calmed things, by allowing me to fill my system, without overwhelming it.

if you do not have the chance to indulge such a gradual dose increase, the wisdom of take on a full stomach and then eat a little but more is sound. i take mine about 75% way through a decent, sit down kind of meal.

i also take a full strength aspirin daily during breakfast. i do this for blood health, but this too allegedly helps with flushing effects of Tecfidera.

and then comes the question of booze… to be concise, there is no question. i have not suffered an ill-effects from having tecfidera and alcohol cohabiting my belly. nor have i heard reports that one can negatively affect / neutralise the other. to my (possible) shame, i have even downed a drunken evening dose of Tec with a swig of an oat soda! so don’t worry :slight_smile:


You should not drink alcohol within an hour of taking Tecfidera,it interacts with the drug and can cause inflammation of the stomach (gastritis).

I took the higher dose after one week at the lower dose. I just make sure I eat before. No side effects apart from slight flushing occasionally but I know we are all different. Good luck

where did you find this information please?

When I started Tec. about 18 months ago the leaflet, that came with it, gave not to drink neat spirits (I think it was clarified > 30% by volume alcohol) with in 3 hours. I do like neat whiskey and came close to to the 3 hour limit this Christmas and did experience some uncomfortable gastroesophageal reflux disease.

interesting… the Biogen Idec product info sheet which comes with my capsules doesn’t mention alcohol intake considerations at all.

i will look into this further, as currently i consume booze willy nilly with respect to tecfidera dosing. considering that this drug is supposed to be of benefit over ‘the long haul’, i would hate it if an avoidable behaviour was subsequently found to negate any beneficial effects.

i mean, i am happy, willing and able to abstain from bevvies for x number of hours following a dose of Tec… but what about (for example) taking your second, evening dose on a belly full of beer?

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This is now to another drug but I went the website and was able to search ( for Tecfidera.

Consumption of more than a small quantity (more than 50 ml) of strong alcoholic drinks (more than 30% alcohol by volume, e.g. spirits) should be avoided within an hour of taking Tecfidera, as alcohol can interact with this medicine. This could cause inflammation of the stomach (gastritis), especially in people already prone to gastritis.

Patient information leaflet 9PIL0

an excellent resource; many thanks to you!

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I was on the Tecfiera/aspirin trial.

I was told not to have alcohol within an hour of taking Tecfidera.

I was not allowed alcohol over 30%.

I was told to drink in moderation because alcohol had a negative effect when taken with Tecfidera (they didn’t say what the negative effects were)

I am not a big drinker but i do like the odd glass of wine. I have been fine with this.

I have had a couple of glasses of brandy over xmas which is over 30% and i have been fine also. I think moderation is key really - as long as you are not a regular heavy drinker you should be fine.

My neurologist has asked me several times during the trial about my alcohol consumption so it must be important.

My normal consumption is about 2 glasses of wine a week which the neuro said was absolutely fine.

If you are a regular drinker it might be an idea to check with your neuro or cut down a bit.

Teresa. x