Dermatology (Skin conditions)

Fumaric Acid Esters

This information aims to tell you about fumaric acid esters (FAE) and its use in treatment moderate to severe psoriasis.

What is Fumaric Acid Esters?
FAE tablets are unlicensed in the UK and therefore only available be special arrangement through our hospital pharmacies. This drug has been used for many years in Germany. The tablets come in two different strengths; low strength 30mg white tablets) and high strength (120mg blue tablets). The low strength box contains 40 tablets and the high strength box contains 50 tablets.

How is FAE taken?
The tablets are ‘enteric coated’ which means that they will pass through the stomach and be absorbed in the small intestine. It is important that they are swallowed whole and not chewed. The tablets should be taken with or after a meal. It is also advisable to drink plenty of fluids when taking these tablets.
When FAE is given as a new treatment the dose will be increased each week to let your body get used to the drug. The doses you are given will depend on your response to the drug.

FAE and other medicines

  • FAE is not known to interact with other medicines
  • Always tell your doctor if you start taking any medication or have any vaccinations
  • Do not take ‘over the counter’ medicines without talking to your doctor
  • Drugs that can affect the kidneys should be avoided including non-steroidal anti-inflammatory drugs e.g. voltarol, indomethacin, ibuprofen and naproxen. They are also found in some cold remedies.
  • For pain relief paracetamol or codeine may be taken
  • If you feel unwell, inform your GP immediately

Is FAE safe in pregnancy?
You should avoid becoming pregnant whilst taking FAE and should use a reliable form of contraception during treatment and for one month after treatment. Please tell your doctor if you think you may be pregnant.

Can FAE cause side effects?
Some side effects are very common. These include nausea, stomach pain, cramps, wind, feeling bloated and diarrhoea. These usually get better after a while. Flushing and a sensation of heat in the skin can also occur which will subside with time. If any of the side effects are too bad the dose may be lowered or the treatment stopped.

What monitoring will be required?
FAE may affect your liver, kidney and blood cells. This is why we check your blood and urine regularly. FAE may reduce the white cells in your blood, which help fight infection. This may in part be how FAE works in the treatment of psoriasis. Very occasionally the white blood cell level become sufficiently low to increase the risk of infection and treatment levels will be adjusted to prevent this happening.

Can I drink alcohol with FAE?
Yes. However it is better to drink in moderation (if at all) as both alcohol and FAE can affect the liver.

Any further questions?

If you have any queries or concerns about FAE please feel free to ask your dermatologist when you attend your appointment.

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