Tecfidera: Sidestepping the Side Effects
Physicians prescribe, and we take, medications because they have a desired effect and produce a positive outcome. For example, with MS disease-modifying therapies the positive outcomes are a reduction in disease activity and disability progression. Sometimes a medication produces more than the desired effect and causes a problem. These worrisome outcomes can be adverse events or allergic reactions. Adverse events—undesired complications that are harmful and/or dangerous—are what most concern doctors. An example of an adverse event is PML. While it is unusual and infrequent, it is dangerous and medical providers carefully watch for it. Allergic reactions happen when the body's natural defense system overreacts. While they can be severe, more often they are resolved quickly—often by taking Benadryl.
Side effects—a phrase we often hear but may not fully understand—are different. Side effects are the undesired consequences that occur as a result of taking a medication, and while they can be annoying and troublesome, they are not generally dangerous and can be managed. Any change results in a side effect, or in other words, a consequence or outcome. Changing your diet has side effects: you may lose weight or have more energy. Having a child has side effects: you will sleep less and feel more tired, and likely experience a change in priorities and daily rhythms. Likewise, taking an MS medication has desired side effects: it can result in less or no new lesions (which demonstrate reduced disease activity) and fewer or no exacerbations. It can also result in everyday side effects that can be more challenging; for example, flu-like symptoms.
The good news is that these side effects are generally anticipated and can usually be well managed. Simply adhering to certain practices help. Tecfidera (BG-12), which was approved by the FDA in March 2013, is a good example. As you can read here, phase II and III studies demonstrated the drug’s efficacy and safety. Because of this and the fact that it is an oral medication, FDA approval of Tecfidera was highly anticipated and since its emergence it has been prescribed for many patients. However, as with most medications, Tecfidera can result in some challenging side effects. These few important reminders for patients on the therapy can help:
- Know about the two common side effects that patients on Tecfidera may encounter: flushing and stomach problems. Flushing can include redness, itching or rash, and stomach problems can include nausea, vomiting, diarrhea, stomach pain or indigestion. Both flushing and stomach problems generally decrease over time.
- If you have pre-existing stomach problems, talk to your medical provider before taking Tecfidera. There are pre-treatment strategies that often help reduce or eliminate these issues. There are pre-treatment strategies that can help manage flushing as well.
- Always take Tecfidera with morning and evening meals. Taking Tecfidera with food helps the body better absorb it. It is also recommended to take it at the same time daily.
- Tecfidera side effects can be worked through and it is critical not to give up on the medication. If side effects begin to interfere with daily activity, contact your medical provider to discuss how to manage them.