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dimethyl fumarate (Tecfidera, BG-12)

Indications: - relapsing multiple sclerosis Contraindications: - not for rapidly evolving severe multiple scleorosis [NGC:NICE] Pregnancy category: C Dosage: - 240 mg PO BID-TID Capsules: 240 mg Storage: - store in orginal container - must be protected from light - must be used within 90 days once original bottle is opened (U.S. product labeling only) [4] Manitor: - CBC: lymphocyte count every 6 months* [6] * more frequent monitoring after administration in 1st 6 months Adverse effects: - lymphopenia - flushing - nausea, vomiting, abdominal cramping & diarrhea - especially at the start of therapy - GI effects may decrease over time - case report of progressive multifocal leukoencephalopathy (PML) [5]

General

ester neurologic agent

Database Correlations

PUBCHEM cid=637568

References

  1. FDA News Release: March 27, 2013 FDA approves new multiple sclerosis treatment: Tecfidera
  2. Gold R et al. Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N Engl J Med 2012 Sep 20; 367:1098. PMID: 22992073 - Fox RJ et al. Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis. N Engl J Med 2012 Sep 20; 367:1087. PMID: 22992072
  3. Prescriber's Letter 20(5): 2013 New Drug: Tecfidera (Dimethyl Fumarate) Detail-Document#: 290512 (subscription needed) http://www.prescribersletter.com
  4. Prescriber's Letter 21(6): 2014 Oral Meds to Keep in Original Containers Detail-Document#: 300622 (subscription needed) http://www.prescribersletter.com
  5. FDA Drug Safety Communication: Nov 25, 2014 FDA warns about case of rare brain infection PML with MS drug Tecfidera (dimethyl fumarate). http://www.fda.gov/Drugs/DrugSafety/ucm424625.htm
  6. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015