Tecfidera (dimethyl fumarate) is a prescription oral capsule used to treat two types of multiple sclerosis (MS) and clinically isolated syndrome. This drug can interact with some other medications, such as certain other MS treatments.
Tecfidera is used in adults to treat:
- relapsing-remitting MS
- active secondary progressive MS
- clinically isolated syndrome, an episode of MS-like symptoms that may or not turn into MS
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Tecfidera’s possible interactions. And for more information about Tecfidera, including details about its uses, see this article.
Before you start taking Tecfidera, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Tecfidera interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Tecfidera?” section.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Tecfidera. Keep in mind that this table does not include all drugs that may interact with Tecfidera. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| drugs similar to Tecfidera | • diroximol fumarate (Vumerity) • monomethyl fumarate (Bafiertam) | can increase the risk of side effects from Tecfidera and the other drug |
| immunosuppressants or immunomodulators for MS | • alemtuzumab (Lemtrada) • ocrelizumab (Ocrevus) • ofatumumab (Arzerra, Kesimpta) • ozanimod (Zeposia) | can increase the risk of infections |
Certain health conditions or other factors could raise your risk of harm if you take Tecfidera. In such cases, your doctor may not prescribe Tecfidera for you. These are known as contraindications. Allergic reaction is the only known contraindication of Tecfidera.
If you’ve had an allergic reaction to Tecfidera or any of its ingredients, your doctor likely won’t prescribe Tecfidera for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Tecfidera is not known to interact with alcohol. But Tecfidera and alcohol can cause some similar side effects, such as flushing, diarrhea, and nausea. So drinking alcohol during your Tecfidera treatment may increase your risk of these side effects or worsen them.
Drinking large amounts of alcohol can lead to liver damage. Tecfidera can also cause liver damage, so you may have a higher risk of liver problems if you drink alcohol while taking Tecfidera.
If you have questions about combining alcohol and Tecfidera, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Tecfidera.
Interaction with drugs similar to Tecfidera
Tecfidera can interact with drugs similar to Tecfidera, which are also used to treat MS.
Examples of these medications include:
- diroximol fumarate (Vumerity)
- monomethyl fumarate (Bafiertam)
What could happen
Tecfidera and similar drugs can cause some of the same side effects. Examples include flushing, liver damage, and digestive side effects such as nausea and vomiting. So you may have a higher risk of experiencing these side effects if you take Tecfidera with a similar drug.
What you can do
Your doctor likely won’t prescribe Tecfidera with similar drugs, such as those listed above. You can ask your doctor about other treatments that may be better options for you.
If you have questions about taking Tecfidera with similar drugs, talk with your doctor or pharmacist.
Interaction with immunosuppressants or immunomodulators for MS
Tecfidera can interact with immunosuppressants or immunomodulators used to treat MS.
Examples of these drugs include:
- alemtuzumab (Lemtrada)
- ocrelizumab (Ocrevus)
- ofatumumab (Arzerra, Kesimpta)
- ozanimod (Zeposia)
What could happen
Immunosuppressants weaken your immune system (your body’s defense system). Immunomodulators change activity in part of your immune system. Both types of drugs can raise your risk of an infection.
Tecfidera is an immunomodulator, so combining it with other immunomodulators or immunosuppressants may further raise your risk of developing an infection.
What you can do
Your doctor will likely avoid prescribing Tecfidera with other immunomodulators or immunosuppressants for MS, such as those listed above. You can ask your doctor about other treatments that may be better options for you.
If your doctor prescribes Tecfidera with one of these drugs, tell them right away if you develop symptoms of infection. These can include fever, cough, and flu-like symptoms.
If you have questions about taking Tecfidera with other immunomodulators or immunosuppressants, talk with your doctor or pharmacist.
Tecfidera may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that this information does not include all other possible interactions with Tecfidera.
Does Tecfidera interact with supplements?
Before you start taking Tecfidera, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Tecfidera and herbs
There are currently no reports of Tecfidera interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Tecfidera.
Tecfidera and vitamins
There are currently no reports of Tecfidera interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Tecfidera.
Does Tecfidera interact with food?
There are currently no reports of Tecfidera interacting with food. If you have questions about eating certain foods during your treatment with Tecfidera, talk with your doctor.
Does Tecfidera interact with vaccines or lab tests?
There are currently no reports of Tecfidera interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during your Tecfidera treatment, talk with your doctor.
Does Tecfidera interact with cannabis or CBD?There are currently no reports of Tecfidera interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Tecfidera.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Tecfidera. Before taking Tecfidera, talk with your doctor about your health history. They’ll determine whether Tecfidera is right for you.
Health conditions or other factors that might interact with Tecfidera include:
Low white blood cell count: Tecfidera can lower your level of white blood cells, which can further raise your risk of infection. If you already have a low white blood cell count, talk with your doctor about whether Tecfidera is right for you.
Liver problems: In rare cases, Tecfidera can cause liver damage. If you already have a liver problem, Tecfidera could make it worse. Talk with your doctor about whether Tecfidera is safe for you.
Pregnancy: It’s not known whether Tecfidera is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Tecfidera treatment.
If you do take Tecfidera while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Tecfidera. To learn more, call 866-810-1462 or visit the registry website.
Breastfeeding: It’s not known whether it’s safe to take Tecfidera while breastfeeding. It’s not known if the drug passes into breast milk or whether it may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Tecfidera or any of its ingredients, your doctor will likely not prescribe Tecfidera. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Tecfidera. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Tecfidera treatment
It’s also important to understand Tecfidera’s
If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Taking Tecfidera exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.