Has anyone advise on exactly what to eat for breakfast and evening meal before tecfidera? Sample menu’s would have been good with the guidelines when given the tablets and info on side-effects.

I eat a normal diet.

Whatever you have always eaten.

For me - that is branflakes with milk and fruit. Then cup of coffee. Then the Tecfidera.

Ive been on Tecfidera 9 months. Ive had no stomach issues.

If you experience stomach issues with your normal diet - then add some fat - such as toast with butter.

You may not have to make changes at all.

If you want to be cautious when starting Tecfidera - then start with the breckie with some fat and then if you are symptom free then drop it from your diet.

I didn’t want to eat a fatty diet if it wasn’t necessary - and for me - it isn’t.

We are all different and it will be trial and error to see what works for you.

Good luck



I have been on tec for 7 weeks now.I was told by my ms nurse to take egg with toast or toast and soft cheese.I sometimes take cereal and then a slice of toast with cheese I have found if you take tec half way through breakfast or dinner it helps to stop any tummy issues.I have a normal dinner at night.

Good luck Anne.

My MS nurse told me something that was protein based so she suggested egg on toast. I did my own research and found a lot of people were having a meal then taking their tablet 30 mins after with some peanut butter. For the first 3 weeks I had eggs on toast then peanut butter with my tablet. Iv had really minimal side effects. Now I’m on week 5 and I just have a decent meal with my tablet mainly based around proteins. Hope that’s some help x

thank you all for your prompt responses, most helpful.

I had a letter to say take with or after ‘fatty’ food and indigestion tablet. I thus started the low dose after taking indigestion tablet then 30 mins later having a meal with ‘fat’ included ie had sausage, lamb, mince, bacon with veg or rice and for breakfast a little porridge and then a slice of cheese on toast. I usually only have the porridge or a little cereal and don’t usually have high fat meals tend to go for chicken or fish (as can put weight on very quickly). Anyway, no problems for the 1st week of low dose, then went onto high dose, followed same regime but after 5 days was physically sick and feeling yuk and as couldn’t get any response from my hospital team decided to stop until advised. Finally was advised could collect a month of low dose and hopefully all would then be ok to move onto high dose after that, but a different person at the hospital advised protein not fat hence the confusion. So yesterday just restarted low dose and after reading each of your comments i think i will eat my normal food and not sure about taking the indigestion tablet, have any of you been doing that?

i really want the oral med to work as have been on rebif injection for 7 years and my injection sights have had enough.

I’ve been on it for 2 months and much better than injections. Def worth persevering.

i was told protein, no mention of fat. Sometimes i have it with breakfast (muesli and milk) and other days with lunch. Like others have said, take it in the middle of a meal to sandwich it between food and protect your stomach. I find milk and yoghurt are good. I did get indigestion at first and took antacids when I needed them.

I personally find it hilarious (and tragic) the elaborate advice given regarding dietary considerations whilst taking tecfidera;

“Eat a meal of 42.5% lipid content, then precisely 17 minutes afterwards, take you tecfidera whilst reciting ‘Mary had a little lamb’ backwards, whilst stroking a dacshund called raymond, with a ladle of peanut butter made from almonds…”

the long and the short of it: eat whatever you want. if tecfidera gives you a convenient excuse to eat a block of lard, then go for it. if you would rather not have fat in your diet, then do not. the key is to eat enough so you feel almost full, then take your pill, then have a few more mouthfuls of grub.

and incidentally, if you are not a big breakfast person (and many are not), why not postpone your first daily dose until lunch time, when you are more happy to chomp down an entire late full? as long as you are not going to take your second daily pill within the four hours following, you have followed the dosing direction completely.

ultimately, the point is this, taking tecfidera does nothing, absolutely nothing towards requiring a change in lifestyle, habits or diet. this includes, more protein, less fat, or dogs called raymond.

it is as simple as you would want it to be!

good luck and don’t worry.

oh and yes, do not be in any hurry to march on up to 100% full dosage, especially if doing so makes you feel even slightly pukey!

Aargh! Feeling rather apprehensive now as I’ll be starting on the high dose tomorrow after a month on the lower one. I take 10mg of omeprazole half an hour before the dose at breakfast and dinner, (agreed with my MS Nurse) and I swallow the Tec in the middle of the meal as recommended by the good folk on here.

I was having protein and a little fat (tablespoon of Hellman’s mayo) at breakfast and a normal dinner, but since I’m on Slimming World and make meals accordingly I’m not adding fat to anything else. I try and make sure that I have a big Slimming World friendly breakfast and dinner.

Had a few side effects but I can cope. Truthfully, the fourth week has been the worst with various annoying symptoms but I realise that these might well just be my body kicking off as the Tec gets ready to bed into my system. But I’m just glad to be on it at the moment. I was only diagnosed at the beginning of this year and this is my first DMD and is said to be the most effective so I’m really glad to have the chance to try it.

I haven’t yet resorted to the peanut butter - I absolutely love it and can’t eat it in moderation so would rather avoid it completely!

Good luck


with all things considered Louise, your apprehensive anxiety probably causes you a greater sense of nausea than tecfidera will


your bod has had an entire month to grow accustomed to your new ‘dietary supplement’. i doubt it will even notice the higher dose

but if you have to endure the consumption of peanut butter to help smooth this transition (even if only psychologically) then do it. just try not to eat more than one jar at a time.