Starting Tecfidera tomorrow any tips

starting my Tecfidera tomorrow, just wondered if anyone has any tips on diet or meds for the side effects?

Btw, I was going to have a bowl of high protein musli with semi skimmed milk with sliced banana, what do you think?

I’ve been on tecfidera for 4 months. Best advice I can give is to have a protein based breakfast wait 30mins and take your tec with a spoonful of peanut butter. I swear by the peanut butter. I had really minimal side effects just a bit of a stomach ache the first few days. Good luck xx

Hi Em Gem. There is lots of good advice on this forum from other Tec users (especially Paolo Smythe) so well worth doing a search.

Also the Facebook group is really good and worth joining, with lots of info.

I’ve been on Tec for almost six months and I’m fine with it. I prepared very carefully for it at the beginning and asked to have the lower dose for four weeks instead of one, and I think this helped.

Best of luck


in my opinion (for what it might be worth)…

your greatest side effect will probably be self inflicted nervousness / anxiety. the remedy for this is a positive mental attitude.

a few facts: this is the best drug there is for you in your circumstances. no needles are involved. the side effects are minimal, are easily managed if they do occur and will be short lived.

in the absolute worst case scenario, if you find your side effects to be intolerable (highly as unlikely as that is,) you can stop taking the Tecfidera and it will be out of your system completely in less than half a day.

to help you on your merry way, i would recommend you do the following:

  • do not force yourself to have breakfast if you do not usually have it. wait for lunch;

  • take an adult strength aspirin 30 minutes before the tecfidera dose #1. this will sort out any flushing / itching / etc;

  • take the tecfidera when you are three quarters of your way through a good sized meal. ie. NOT an empty stomach;

  • ‘good sized meal’ does not mean you need to eat more than you usually do; it just means you should feel full by the end of it;

  • eat whatever you normally eat. proteins, fats, alcohols, sugars… it doesn’t matter. your dietary habits do not need to change one bit;

  • if you get stomach cramps, take a paracetamol;

-if you get flushing / itching / etc take an anti-histamine.

hopefully you have been provided with a good number of the 120mg capsules. take one daily for week one, two daily for week two, three daily for week three and then full dose of four a day in week four.

if at any stage you feel side effects are too much, take one fewer capsule daily. if after a few weeks on full dose you are all good, request the 240mg capsules and take those twice a day.

good luck and don’t stress. tecfidera is a doddle. it is quite likely that you will not need to follow most of the above; it is what i advise based upon my own experience of tecfidera munching over the last 9 - 10 months.


I have the aspirin and antihistamine ready just in case. I will be having my first dose at about 11am with my musili and have a peanut butter snack at the ready just in case to see me through till lunch. I have a dinner planned of chicken with pasta and a full fat yogurt for after at about 8pm. Should be ok I think

the ONLY rule for taking Tec: no two doses within 4 hours of each other.

that is the only rule. it truly is that easy!

I like my food usually with a kick of chilli, I have heard spicy and citric fruit doesn’t sit well, any truth in that?

I like a crab linguine with Chilli and lime I hope I don’t have to give that up

I have nearly completed week 4 of Tec. I had 1 week of low dose then straight onto higher dose. First 2 weeks were fine, I had a bigger breakfast than normal-either scrambled egg on toast or toast and jam/chocolate spread and yoghurt. For evening meal I ate my normal meals that I cook for the family. Week 3 I had some side effects-tummy cramps and bloating which was uncomfortable. I took buscopen and I bought an aloe vera digestion juice from Holland and Barrett. These really helped. I also take omeprazole before meals which I have already on prescription from my GP. I also had 3 brief episodes of flushing on separate days which lasted about 15 minutes and I didn’t take anything for these.This week wk4 I have not had these side effects at all and feel really good. Hope this lasts. Hopefully you will be fine. I go for my 1st month blood test tomorrow.

All the best


if i might refer you to the line whcih states:

‘- eat whatever you normally eat. proteins, fats, alcohols, sugars… it doesn’t matter. your dietary habits do not need to change one bit;’


Thanks cat, I have a Holland and Barrett next door so I will get some of that. Good luck with the blood test.

i hope your right as its my weekly treat!

Hi em gem I start my tecfidera on friday when it comes just wondering how it’s been

I had my first one this morning with my high protein Muslim with semi skimmed milk at about 11am after taking one aspirin half an hour before, then had an egg mayo sarnie for lunch and a yogurt and touch wood, I didn’t have any side effects.

Just had the second dose with my dinner which was sweet chilli chicken and wholemeal rice so hopefully no issues tonight.

like Paolo said, just do it and whatever happens happens, there are plenty of over the counter drugs to help with any side effects but I just took the aspirin.

I will see what tomorrow brings but fingers crossed for you

So sorry but I meant muesli but it auto corrected to Muslim!

1 Like

best auto-correct typo - ever

Good job I re read it!

Thanks just got my txt from bupa coming 8 till 10 I’ll look forward to that. Are you on 120g for 7days then up to 240g?

Yes I am on 120 for 7 days then 240 after that. Good luck, I hope you have your meals ready!

Yep got my bacon at the ready lol gonna sort my 7day meals too. How does the 240g work will they be 2x 120g morning and night just freaking out lol.