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