A patient develops troublesome flushing and gastrointestinal discomfort during the first week after dimethyl fumarate was increased to 240 mg twice

Question

A patient develops troublesome flushing and gastrointestinal discomfort during the first week after dimethyl fumarate was increased to 240 mg twice daily. There is no rash, anaphylaxis or laboratory abnormality. Which strategy is authorised to improve early tolerability?

Accepted Answer

Take with food; use 120 mg twice daily temporarily, then resume 240 mg twice daily within one month

Answer

Take fasting and add aspirin 325 mg before every dose while continuing 240 mg twice daily indefinitely

Answer

Change to 240 mg on alternate days as the authorised long-term maintenance regimen

Answer

Interrupt treatment for three months, then restart directly at 240 mg twice daily without retitration

Answer

Reduce to 120 mg once daily permanently because any subsequent dose escalation is contraindicated

DMF – Flushing Management — SCE Neurology MCQ

A patient develops troublesome flushing and gastrointestinal discomfort during the first week after dimethyl fumarate was increased to 240 mg twice daily. There is no rash, anaphylaxis or laboratory abnormality. Which strategy is authorised to improve early tolerability?