If Tecfidera isn’t available at your hospital, maybe your neurologist can refer you to another Neuro who is able to prescribe it. Honestly it is a much better option to start with something that actually is likely to give fewer side effects long term and be a whole load more effective at reducing relapses. Reducing relapses is the most important thing you can do at this stage of your MS and 50% is obviously a better option than 30% reduction.
The side effects most commonly suffered by Avonex users is flu like symptoms (hence the paracetamol and/or ibuprofen). The side effects suffered by Betaferon and Rebif are similar. Copaxone may give injection site reactions (as can the other injectables) but may be relatively side effect free. Tecfidera typically gives an upset stomach initially but that can usually be managed and will go within the first few months of use.
My neurologist is now able to prescribe most DMDs but some of them are not able to prescribe Tysabri, Tecfidera, Gilenya and/ or Lemtrada (amongst others). A few years ago, my neurologists’ local prescribing centre hadn’t been set up so he referred patients (me included) to a variety of other hospitals, depending on which ones individuals could get to. He basically wanted his patients to get the most effective treatment available as fast as possible. Once his (eg) Tysabri clinic was set up, he gradually moved all his patients back locally.
I know it may delay the start of your DMD slightly but it would (in my opinion) be better to make the most informed decision about DMD that you can. Many of us have decided preferences for one over others but in general that’s because we’ve tried others and think the one we’re on is the easiest and/or most effective given our lifestyle.
By by the way, I’ve had Avonex, Copaxone, Tysabri and am currently on Tecfidera. I believe Tysabri is the very best treatment but I had a problem with my liver when I was on it, it is also less easy to fit into lifestyle as you have to more or less give up one day a month to it. Tecfidera is in my opinion a far better drug than any beta-interferon or Copaxone.
You have my sympathy, just being diagnosed with MS is hard enough, but managing to navigate your way around the various drug treatments is hell on earth!