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Dimethyl fumarate (DMF) is the methyl ester of fumaric acid. DMF was initially recognized as a very effective hypoxic cell radiosensitizer. Later, DMF combined with three other fumaric acid esters (FAE) was licensed in Germany as oral therapy for psoriasis (trade name Fumaderm). Other diseases, such as necrobiosis lipoidica, granuloma annulare, and sarcoidosis were also found to respond to treatment with DMF in case reports or small patient series. Phase III clinical trials found that DMF (BG-12) successfully reduced relapse rate and increased time to progression of disability in multiple sclerosis (trade name Tecfidera). DMF is thought to have 'immunomodulatory' properties .

In a non-medical use, DMF was applied as a biocide in furniture or shoes to prevent growths of mold during storage or transport in a humid climate. However, due to incidences of allergic reactions after skin contact the European Union banned DMF in consumer products since 1998, and since January 2009 the import of products containing DMF was also banned.

The precise mechanism of action of dimethyl fumarate is unknown [sic].

The compound (and its metabolite, monomethyl fumarate) activates the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway and has been identified as a nicotinic acid receptor agonist in vitro. Dimethyl fumarate is a lipophilic, highly mobile molecule in human tissue. As a α,β-unsaturated electrophilic compound, dimethyl fumarate is rapidly attacked by the detoxifying agent glutathione (GSH) .

Most common Tecfidera side effects from eHealthme

• Skin blushing/flushing - (9,838 reports)
• Nausea - (5,808 reports)
• Diarrhea - (5,185 reports)
• Nausea and vomiting - (3,641 reports)
• Fatigue - (3,428 reports)
• Abdominal pain upper - (3,377 reports)
• Itching - (2,913 reports)
• Rashes - (2,847 reports)
• Headache - (2,635 reports)
• Multiple sclerosis relapse - (2,619 reports)

On Feb, 07, 2017  54,478 people reported to have side effects when taking Tecfidera.
Among them, 312 people (0.57%) have Death

On Feb, 14, 2017  54,478 people reported to have side effects when taking Tecfidera.  Among them, 77 people (0.14%) have Hallucination

On Feb, 14, 2017  54,478 people reported to have side effects when taking Tecfidera.  Among them, 12 people (0.02%) have Hallucination, Auditory