Do certain foods cause flushing?

Here is My Question:
I just started taking Tecfidera today. I took it around 11 am, and made sure to eat healthy fats with it (my doctor recommended this). I was fine up until 3:30-3:45, and then the flushing kicked in. I was wondering if eating certain foods may cause flushing? I know this is a side effect of the medication, but I ate some spicy chili at 3, and then the flushing started. I was fine all day up until then. Other than that I've had no other side effects (cross my fingers).

Answer:
Flushing is a common side effect of Tecfidera. Clinical trials 36% of people taking dimethyl fumarate reported experiencing flushing and 42% reported gastrointestinal (GI) upset such as nausea, vomiting, abdominal pain or diarrhoea. These side effects tend to occur in the first month or so of treatment before easing off, however they can be troublesome to deal with and it is known that experiencing these symptoms can affect how many people stay using treatment. If side effects such flushing or GI upset can be effectively managed then it is likely more people will continue dimethyl fumarate treatment and benefit from its disease modifying effects.The suggested strategies to reduce the impact and severity of flushing and GI upset include:

• taking dimethyl fumarate with food
• temporarily reducing the dose, returning to full dose within four weeks
• taking aspirin before the dimethyl fumarate dose to reduce flushing
• using loperamide to manage diarrhea
• using metoclopramide or domperidone to manage very severe nausea or vomiting
• using H2-receptor antagonists and proton pump inhibitors to help reduce abdominal pain.

Augusto Miravalle, MD FAAN
Clinical Associate Professor of Neurology
Liaison for Neurology, Fort Collins Branch
University of Colorado Denver School of Medicine