Dimethyl fumarate and Orphenadrine, aspirin, and caffeine interaction

Dimethyl fumarate and Orphenadrine, aspirin, and caffeine: the Dimethyl fumarate prescribing label flags this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Dimethyl fumarate (TECFIDERA) label · effective 2025-06-04

Major

Serious Gastrointestinal Reactions Serious gastrointestinal reactions, including perforation, ulceration, hemorrhage, and obstruction, some with fatal outcomes, have been reported in the postmarketing setting with the use of fumaric acid esters, including TECFIDERA, with or without concomitant aspirin use.

Warnings and precautionsnames Orphenadrine, aspirin, and caffeineView label on DailyMed
Moderate

Alternatively, administration of non-enteric coated aspirin (up to a dose of 325 mg) 30 minutes prior to TECFIDERA dosing may reduce the incidence or severity of flushing [see Dosing and Administration ( 2.1 ) and Clinical Pharmacology ( 12.3 )] .

Warnings and precautionsnames Orphenadrine, aspirin, and caffeineView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.