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Dimethyl Fumarate (Tecfidera)

Immunosuppressantprescriptionoral · inferred

Orally bioavailable fumaric acid ester prodrug rapidly hydrolyzed by intestinal esterases to monomethyl fumarate (MMF), the active Nrf2 (NFE2L2) pathway activator with immunomodulatory and antioxidant effects. Approved for relapsing-remitting multiple sclerosis and psoriasis. Dose 240 mg PO BID (titrated from 120 mg BID over 7 days). Parent dimethyl fumarate effectively undetectable in plasma; MMF t1/2 ~1h (short, but repeat BID dosing and long downstream Nrf2 signaling provide sustained effect). F~22% (active MMF). Common AEs: flushing (aspirin 325 mg 30 min pre-dose mitigates), GI upset, lymphopenia (monitor ALC - PML risk if prolonged severe lymphopenia).

Projected serum levels — 240 mg, twice daily

Dimethyl Fumarate (Tecfidera) (precursor)
Dimethyl Fumarate (Tecfidera) modeled serum levels, 240 mg twice daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 25 50 75 100 Day 0 Day 4 Day 7 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 240 mg twice daily (oral).

Modeled steady state after ~1 days: peak ≈ 34.5 mg, trough ≈ 0.000 mg body load. Population-based estimate over 15 days for a 240 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Immunosuppressant
Route modeled
Oral
Model confidence
inferred
Half-life
1 h
Common dose
240 mg
Suggested maximum
480 mg/day
Reference dose range
120–480 mg (single dose)
Suggested cadence
twice daily
Validated against
240 mg oral — Cmax 1.7 mg/L at 2.5 h

Documented interactions

  • watch
    Astaxanthin + Dimethyl Fumarate (Tecfidera) Stacked effects

    Astaxanthin and Dimethyl Fumarate (Tecfidera) both push the nrf2 in the same direction.

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    Black Seed Oil (Nigella sativa / Thymoquinone) + Dimethyl Fumarate (Tecfidera) Stacked effects

    Black Seed Oil (Nigella sativa / Thymoquinone) and Dimethyl Fumarate (Tecfidera) both push the nrf2 in the same direction.

  • watch
    Glutathione (Injectable) + Dimethyl Fumarate (Tecfidera) Stacked effects

    Dimethyl Fumarate (Tecfidera) and Glutathione (Injectable) both push the nrf2 in the same direction.

  • watch
    Green Tea Extract (Camellia sinensis) + Dimethyl Fumarate (Tecfidera) Stacked effects

    Dimethyl Fumarate (Tecfidera) and Green Tea Extract (Camellia sinensis) both push the nrf2 in the same direction.

  • watch
    Rhodiola Rosea + Dimethyl Fumarate (Tecfidera) Stacked effects

    Dimethyl Fumarate (Tecfidera) and Rhodiola Rosea both push the nrf2 in the same direction.

  • watch
    Sulforaphane (Broccoli Seed Extract) + Dimethyl Fumarate (Tecfidera) Stacked effects

    Dimethyl Fumarate (Tecfidera) and Sulforaphane (Broccoli Seed Extract) both push the nrf2 in the same direction.

Serum checks 8 modeled interaction pairings for dimethyl fumarate (tecfidera) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Pharmacokinetics of oral fumarates in healthy subjects Litjens NHR et al. · British Journal of Clinical Pharmacology, 2004 DOI

    PK study establishing rapid DMF pre-systemic hydrolysis to MMF (parent undetectable), MMF t1/2 ~1h, food delays but does not reduce MMF AUC.

  2. Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis (CONFIRM) Fox RJ et al. · New England Journal of Medicine, 2012 DOI

    Pivotal phase 3 RCT: DMF 240 mg BID reduced annualized relapse rate 44% vs placebo over 2 years in RRMS - supported regulatory approval.

2 published studies referenced in the app, each with a plain-language summary.