Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Disease-Modifying Therapy — Relapsing-Remitting Multiple Sclerosis

Dimethyl Fumarate

Brand names: Tecfidera

Dimethyl fumarate is an oral disease-modifying therapy used for relapsing-remitting multiple sclerosis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Its active metabolite monomethyl fumarate is thought to activate the Nrf2 antioxidant pathway and exert immunomodulatory effects, reducing oxidative stress and inflammatory activity in the central nervous system.

Prescribing in practice

  • Monitor full blood count for lymphopenia, as prolonged severe lymphopenia is associated with progressive multifocal leukoencephalopathy (PML).
  • Flushing and gastrointestinal upset are common, particularly early in treatment, and may improve with time or by taking with food.
  • Liver enzyme elevations can occur, so baseline and periodic liver function testing is advised.

Monitoring

Check full blood count and liver function before starting and periodically thereafter, remaining alert for sustained lymphopenia and new neurological signs suggestive of PML.

Counselling the patient

  • Attend for regular blood tests to monitor white cells and the liver.
  • Flushing and stomach upset are common at first; taking with food may help.
  • Report any new or worsening weakness, confusion or visual or speech problems promptly.

Evidence & guidelines

Efficacy in relapsing-remitting multiple sclerosis was demonstrated in randomised controlled trials (DEFINE and CONFIRM), and it is recommended by NICE.

Reference: NICE TA320 (Dimethyl Fumarate for MS); MHRA Lymphopenia Safety Update; DEFINE/CONFIRM Trials; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways