I’m due to start Tecfidera in the next 10 days and had a few questions regarding diet, drinking and timings.
what kind of fat is best to take the Tecfidera with? Ie saturated, polyunsaturated etc. Does it make a difference? People have suggested peanut butter, and full fat yogurt. What about butter, olive oil, cheese, milk, animal fats etc? And where I’ve read that it’s best to eat protein, carbs and fat, does everyone have to eat a full English breakfast? (Obviously if it’s required then I’ll have to just put up with it
How on earth do you manage to increase the quantity of fat in your diet without putting on a ton of weight? I’m already fatter than I’d like to be!!
Re alcohol, I’ve read about two issues here, one is not to drink for an hour after taking the drug, the second is to not drink anything more than 30% vol (ie spirits). Does this mean it’s ok to drink wine but not spirits within an hour? Or never to drink spirits and only drink <30% vol drinks an hour after taking the drug?
Conversely, can I drink a glass or two of wine with a meal, then take the 'Tec an hour or so after that? This fits in better with my lifestyle as we do tend to drink wine with dinner several nights a week (not talking about breakfast here!).
What about the instruction to take the second daily dose more than 4 hours but less than 12 hours after the first? This doesn’t really make sense. Given that if I took dose one at 9am then dose two at 4pm, my dose one the following day is likely to be 17 or so hours later. Am I missing something here? Does it make more sense to try to space the doses out to roughly 12 hours apart?
I’m thinking that I’ll get up in the morning, take aspirin, vitamins and normal tablets, then shower, dress, exercise, etc. I’ll then eat breakfast comprising of protein, carbs and fat with which I’m take the Tecfidera. This would be about 10 o clock - it takes me a couple of hours most days. My feeling is that I could then eat my dinner at about 7ish, drinking a glass or two or wine with it if I want to, take more aspirin at 9ish then take the second dose of Tec at about 10pm. If necessary I could have a piece of cheese or something with this. I would then have spaced the doses equally and I wouldn’t have to totally give up drinking wine with dinner.
Answers to your Qs from my personal experience (for what it is worth).
it doesn’t matter what you eat, just make sure you are reasonably full. those who specify a certain amount of fat or protein or whatever are talking nonsense. I am more or less fat free, as i adhere to the Swank diet.
you do not.
i drink whatever i like when ever i like. whether this undermines the effectiveness of the drug, only time will tell. have i ever received advice regarding booze from a solid, credible source? not at all. it seems common sensical (not sure why) to take a dose of tec an hour or so before getting bladdered. but many a time, i have gone to bed with a belly full and have taken my second daily dose of tec whilst brushing my teeth.
Take the tec during your meal; between entree and dessert? wash it down with a nice bottle of pinot noir! or just take the tecfidera right before bed time and dont worry about it; you’ll be asleep anyway!
where is this instruction provided? my tecfidera detailed only the ‘no two doses within 4 hours’ rule. and indeed, this is the ONLY rule there is to follow.
I’m thinking that I’ll get up in the morning, take aspirin, vitamins and normal tablets, then shower, dress, exercise, etc. I’ll then eat breakfast comprising of protein, carbs and fat with which I’m take the Tecfidera. This would be about 10 o clock - it takes me a couple of hours most days. My feeling is that I could then eat my dinner at about 7ish, drinking a glass or two or wine with it if I want to, take more aspirin at 9ish then take the second dose of Tec at about 10pm. If necessary I could have a piece of cheese or something with this. I would then have spaced the doses equally and I wouldn’t have to totally give up drinking wine with dinner.
if this plan of action works for you, then do it! sincerely, do it!
the worst thing you can do, is compromise on the quality of your life and the things you enjoy because of taking this drug. that would undermine your reason for taking it! and worst still, is if you decided to stop taking it all together!
good luck and always feel free to ask more questions. we are in this together!
Thanks for the advice. Maybe I’ve been overthinking it! I’ll just relax and try to stick to a normalish routine. Hopefully I’ll be one of the lucky ones who don’t get severe side effects.
I’m on day two of tecfidera and so far it’s good. I was scared.
The instructions i got were take it with food (breakfast & dinner), high protein works best (no mention of fat), minimum 4 hours apart.
I don’t eat breakfast first thing, so I took my first dose mid morning with a yoghurt and a fruit&nut Alpen porridge pot. I felt fine but did get weird hot flush after lunch so took ibuprofen. In the evening I took the 2nd dose with dinner with no effect.
I don’t drink alcohol very often and it didn’t go well with the avonex I was on. It seemed a good excuse to give it up entirely. My ms nurse will be phoning to check up on me next week so might ask her then.
Also read last night that you shouldn’t take ibuprofen with it, so had to go and buy aspirin. I haven’t even opened them yet. I’m glad because I was a bit concerned about taking that many painkillers every day.
today I’ve taken the morning dose with 2 white choc pancakes and a glass of milk. Thought the milk was inspired - a glass of protein! All well.
Have been on tecfidera for about four months now and have not changed my diet however if you are going to have an alcoholic drink give it a couple of hours after taking the tablets as this can increase the side effects.
Other than that the only problem I have had with them was contacting Alcura for redelivery it normally takes about five times to get any joy.
Hi Sue, This thread is from 2015, so I am not sure if you are still taking Tecfidera, but I came across the thread as I am newly diagnosed and starting Tecfidera this weekend. Do you have any advice based on your experience? I am just curious if everything worked out for you so I can plan meals and meds as best as possible so I am not setting myself up for failure. Thank you!
I’m no longer taking Tecfidera nor in fact any disease modifying drug. I had to stop Tecfidera as a result of adverse side effects. I was one of the few people whose lymphocyte count decreased as a result of the drug.
In terms of actually taking Tecfidera, I ended up not altering my diet significantly.
Hopefully you’ll be able to take the drug with no problems. Maybe someone else will comment on their experience.
I started Tecfidera, and within 4 months came off of it. I found that Tec. was completely incompatible with the OMS diet - the biogen hack-nurse even recommended I eat a saturated fat and meat laden meal prior to taking the dose. I’m glad I kicked the Tec. and chose to go the OMS diet way. The pills were making me lethargic, unbalanced and tired along with flushing, runny nose and headaches. Worst, it was making me feel down in the dumps when seeing this deterioration.
As soon as I kicked it, I have become more like my old self. The OMS diet is the healthiest and safest way to confront MS as proven by the HOLISM study and Swank’s research. This along with LDN, I honestly have not felt this good in years, and I was only diagnosed with MS 9 months ago.
Fats don’t have to be unhealthy ones - you can have avocado or peanut butter but of course in moderation.
I’ve been on Tecfidera 240 for a while now (about 2 years) and I found for myself that it is important to eat fatty food before taking the drug. However, what is more important is not to take the drug straight away after a meal. I’ve noticed that when I wait for about 30-60mins after a meal and take my pill then I don’t tend to get flushes. I think it is because I give food time to get absorbed into my body a little before taking the pill.
I’ve learned for myself that just eating fats is not enough to avoid side effects. One of the most important factors is scheduling your drug intake. It is normal (for me at least) to get worse side effects if you change the timings of pills intake or if you miss a pill or the whole day for some reason.
This is what I found works for me - 1. Having a stodgy or fatty meal in moderate portion. 2. Taking the pill half an hour after a meal. 3. Consistency - don’t miss your pills and take them at the same time every day.
