Table 3.

FDA-Approved Oral Disease-Modifying Therapies

Oral Therapies	Dosing	Adverse Effects/Warnings/Precautions
Dimethyl fumarate40	240 mg PO twice d Indication: relapsing forms of MS	Flushing GI symptoms (abdominal pain, diarrhea, and nausea) Pruritus/rash Lymphopenia Potential opportunistic infections, including 4 reported cases of PML that have occurred in the setting of prolonged lymphopenia Pregnancy Category: C
Fingolimod41	0.5 mg PO per d Indication: relapsing forms of MS	Headache Diarrhea Back pain Elevated liver enzymes Macular edema Bradyarrhythmia and/or atrioventricular blocks following first dose administration Caution during treatment initiation in those concurrently taking beta blockers or calcium channel blockers that affect heart rate Elevated blood pressure Lymphopenia Potential opportunistic infections, including 3 reported cases of PML Pregnancy Category: C
Teriflunomide42	7 mg or 14 mg PO per d Indication: relapsing forms of MS	Alopecia GI symptoms (diarrhea and nausea) Hematologic abnormalities Elevated liver enzymes Pregnancy Category: X/risk of teratogenicity

Abbreviations: GI, gastrointestinal; MS, multiple sclerosis; PML, progressive multifocal leukoencephalopathy; PO, by mouth.