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Monomethyl Fumarate

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Why is this medication prescribed?

Monomethyl fumarate is a medication used to treat certain medical conditions, primarily multiple sclerosis (MS). It is available under brand names like Tecfidera.

  • Treatment of Multiple Sclerosis (MS): Monomethyl fumarate is primarily prescribed for the treatment of relapsing forms of multiple sclerosis (MS), which is a chronic autoimmune disease affecting the central nervous system. It helps to reduce the frequency of relapses and slow down the progression of disability in MS patients.

How should this medicine be used?

  • Dosage: The dosage of monomethyl fumarate can vary depending on the specific prescription and individual patient needs. It is typically taken as an oral capsule.
  • Frequency: The usual dosing regimen for monomethyl fumarate involves taking it twice a day, with food.
  • Follow Doctor’s Instructions: It’s essential to follow your healthcare provider’s instructions regarding the dosage and timing of the medication. Do not alter the dose or frequency without consulting your healthcare provider.
  • Taking with Food: Monomethyl fumarate should be taken with food to minimize side effects such as stomach upset. A high-fat meal can help increase the absorption of the medication.
  • Swallow Whole: The capsules should be swallowed whole and should not be crushed, chewed, or opened. Follow your doctor’s advice on how to take them.
  • Adherence: Consistent adherence to your prescribed dosing schedule is crucial for the medication to be effective. Missing doses can reduce its effectiveness.
  • Side Effects: Like all medications, monomethyl fumarate can have potential side effects. Common side effects may include flushing, abdominal pain, diarrhea, and nausea. If you experience severe or persistent side effects, contact your healthcare provider.
  • Monitoring: While taking monomethyl fumarate, your healthcare provider may recommend regular monitoring of your blood cell counts and liver function to ensure your safety and the effectiveness of the treatment.
  • Pregnancy and Contraception: If you are pregnant, planning to become pregnant, or breastfeeding, discuss this with your healthcare provider as monomethyl fumarate may not be suitable, and alternative options may need to be considered. Effective contraception methods may be necessary for women of childbearing potential while taking this medication.

Always consult your healthcare provider or pharmacist for specific instructions on how to take monomethyl fumarate, and make sure to discuss any questions or concerns you have about the medication and its potential side effects. This information is provided as a general overview and should not replace professional medical advice.

Other uses for this medicine

Monomethyl fumarate is primarily approved for the treatment of MS, and its use in other medical conditions is limited. It should not be used for any other purpose without the explicit recommendation and supervision of a healthcare professional.

What special precautions should I follow?

When taking monomethyl fumarate, there are several special precautions to keep in mind:

  • Allergic Reactions: If you are allergic to monomethyl fumarate or any of its components, you should not take this medication. Signs of an allergic reaction may include hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
  • Liver Function: Monomethyl fumarate may affect liver function. Your healthcare provider may monitor your liver function with blood tests while you are taking the medication.
  • Infections: Monomethyl fumarate may increase the risk of infections. Inform your healthcare provider if you develop any signs of infection, such as fever, chills, sore throat, or unusual tiredness.
  • Pregnancy and Contraception: As mentioned earlier, if you are pregnant, planning to become pregnant, or breastfeeding, you should discuss this with your healthcare provider. Monomethyl fumarate’s safety during pregnancy and lactation is not well-established, and appropriate contraception methods may be necessary.
  • Gastrointestinal Symptoms: Some individuals may experience gastrointestinal side effects such as diarrhea, nausea, or abdominal pain. Taking the medication with food can help reduce these symptoms.
  • Flushing: Flushing (redness and warmth of the skin) is a common side effect of monomethyl fumarate, especially when starting the medication. It usually subsides with continued use. Taking aspirin or another non-prescription pain reliever may help alleviate this symptom.

Always follow your healthcare provider’s guidance and inform them of any other medications or supplements you are taking to avoid potential interactions and ensure safe use of monomethyl fumarate. Additionally, report any unusual or severe side effects to your healthcare provider promptly.

What special dietary instructions should I follow?

Take with Food: It is recommended to take Monomethyl Fumarate with food. This can help reduce the likelihood of experiencing common side effects such as nausea, abdominal pain, and diarrhea. A high-fat meal, in particular, may improve the absorption of the medication.

What should I do if I forget a dose?

  • If you forget to take a dose of Monomethyl Fumarate, take it as soon as you remember, but only if it is within a few hours of the scheduled time.
  • If it is close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to make up for a missed one.
  • If you have trouble remembering to take your medication, consider setting an alarm or using a pill organizer to help you stay on track.
  • If you frequently forget doses, or if you have concerns about your ability to adhere to the dosing schedule, discuss this with your healthcare provider. They may be able to provide strategies or alternatives to help you manage your medication regimen effectively.

What side effects can this medication cause?

Monomethyl fumarate is an oral medication used for the treatment of relapsing forms of multiple sclerosis (MS). The most common brand name for this medication is Tecfidera. Like any medication, it can cause side effects. Some of the potential side effects of monomethyl fumarate include:

  • Flushing: This is one of the most common side effects and can cause redness, warmth, itching, and a burning sensation, typically on the face and upper body. Taking the medication with food or aspirin may help reduce flushing.
  • Gastrointestinal Issues: Monomethyl fumarate can cause stomach upset, including nausea, vomiting, diarrhea, and abdominal pain. Taking the medication with food can help alleviate these symptoms.
  • Infections: It may increase the risk of infections, including upper respiratory tract infections and urinary tract infections.
  • Liver Function Abnormalities: Some people may experience changes in liver function tests while taking monomethyl fumarate. Regular monitoring of liver function is usually recommended during treatment.
  • Low White Blood Cell Count: Rarely, monomethyl fumarate can lead to a decrease in white blood cell count (lymphopenia), which may increase the risk of infections.
  • Allergic Reactions: Although rare, some individuals may experience allergic reactions such as itching, swelling, or rash.
  • PML (Progressive Multifocal Leukoencephalopathy): While the risk is considered low, there have been cases of PML associated with monomethyl fumarate. PML is a rare and serious brain infection that can be life-threatening.
  • Other Side Effects: Other less common side effects can include headache, flushing, abdominal pain, indigestion, and a decrease in blood pressure upon standing.

It’s important to note that not everyone will experience these side effects, and many people tolerate monomethyl fumarate well. If you are prescribed this medication, your healthcare provider will closely monitor you and discuss potential risks and benefits. If you experience any unusual or severe side effects while taking monomethyl fumarate, it’s important to contact your healthcare provider promptly. They can adjust your treatment plan or provide guidance on managing side effects.

What should I know about storage and disposal of this medication?


  • Store Monomethyl Fumarate (Tecfidera) at room temperature, typically between 68°F to 77°F (20°C to 25°C).
  • Keep the medication in its original container, tightly closed, and out of reach of children and pets.
  • Protect it from light and moisture. Do not store it in the bathroom or near a sink.
  • Check the product labeling or consult your pharmacist for any specific storage instructions provided with your prescription.


  • Do not dispose of Monomethyl Fumarate or any other medications by flushing them down the toilet or pouring them down the drain unless instructed to do so by your healthcare provider or a drug take-back program.
  • To properly dispose of unused or expired medication, follow local regulations and guidelines for medication disposal. You can often find information on medication disposal options in your community or on the FDA’s website.
  • If you have questions about how to dispose of your medication safely, consult your pharmacist or healthcare provider.

In case of emergency/overdose

  • In case of an overdose or if you suspect you have taken more Monomethyl Fumarate than prescribed, seek emergency medical attention immediately or contact a poison control center at 1-800-222-1222 (United States).
  • Overdose symptoms may include severe flushing, severe stomach pain, severe nausea or vomiting, or other severe side effects. Do not ignore these symptoms, as prompt medical attention is essential.

What other information should I know

  • Keep all appointments with your healthcare provider for monitoring while taking Monomethyl Fumarate. This may include regular blood tests to check your liver function and blood cell counts.
  • Inform your healthcare provider of all the medications (including over-the-counter and prescription medications), supplements, and vitamins you are taking to prevent potential interactions.
  • It’s essential to take Monomethyl Fumarate exactly as prescribed by your healthcare provider and to adhere to the recommended dosing schedule for optimal effectiveness.

Always follow your healthcare provider’s instructions regarding the use and storage of Monomethyl Fumarate. If you have any questions or concerns about the medication, its storage, or what to do in case of an emergency, do not hesitate to reach out to your healthcare provider or pharmacist for clarification and guidance.

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