Tecfidera (dimethylfumarate): a critical review

Medication check: Tecfidera (dimethyl fumarate)

Tecfidera® contains the active substance dimethyl fumarate. The drug is approved for the treatment of relapsing forms Multiple Sclerosis (MS). It has been on the market since February 2014.

Our summary is based on a review of the "Arzneitelegramms", one of the few pharmacological medical journals in Germany.

Mechanism of action of Tecfidera®:

The mechanism of action of Tecfidera® is not yet finalized. Simplified, it can be said that it is an anti-inflammatory. In addition, dimethyl fumarate apparently acts as an antioxidant, thus preventing harmful oxidation processes in the body, which arise in inflammation.

This effect is probably achieved by activation of a so-called transcription factor. Whose name: Nrf2 = Nuclear factor (erythroid-derived 2) -like 2. This is a protein that counteracts oxidative damage caused by inflammation.

Dosage of Tecfidera®:

It is recommended to take 120 mg twice a day in the first week of treatment, then 240 mg twice a day. The tablets are taken with meals.

Effectiveness of Tecfidera® compared to placebo:

Compared with a dummy drug Tecfidera lowered® in studies, the relapse rate by about 45%. In other words: in placebo, about 43% of patients taking placebo experienced a push within two years, under Tecfidera® at 28%.

Whether the progression of disabilities is stopped is not assured.

Effectiveness of Tecfidera® in comparison to other MS drugs:

Tecfidera lies in reducing the rate of relapses® in the midfield of MS-based medicines, for example. In a direct comparison with glatiramer acetate (Copaxone®), there were no significant differences between the active substances.

Side effects of Tecfidera:

The most common side effects of Tecfidera® are so-called flushing symptoms: ie heat spurts, redness of the skin, itching or burning. Around 40% of users experience such complaints. This is especially true for the beginning of the treatment.

A serious side effect is a strong reduction of lymphocytes in the blood, which occurs in about 6% of users. Heavy infections for this reason are not yet documented, but in principle conceivable.


The medicine telegram sees dimethyl fumarate (Tecfidera®) according to current data as a replacement drug for Interferon preparations or glatiramer acetate (Copaxone®), if they are not well tolerated.

Author: Dr. med. Jörg Zorn, May 2016

Do you have your own experiences or a different opinion? Then write a comment (please observe rules).
Comments (2)
2 Wednesday, the 4th of January 2017 at 11:25
It's sad that doctors do not care about the gentle creeping in, which has a positive impact on tolerability. Sadly, no doctor explains that the effectiveness is only after 1 year so high to protect against relapses. Unfortunately, one learns in self-help groups more about the sense and nonsense of the drug.
Most doctors just say .... Keep it up! To possibly try another drug.
Side effects under Tecfidera
1 Tuesday, May 10, 2016 at 15:04
I take Tecfidera since November 2015. Before 2003-2015 Rebif 22 injections, then 3 months Aubagio. With Tecfidera, I have not only flushes several times a day, but also several times a day, an angio-edema. But I hold on, because everything was worse before.