1. 0.5 to 1 mg of glycopyrrolate (Robinul) for GI
2. Baby ASA + 10mg of Zyrtec for flush, hot, etc.
Above taken 30-60 minutes before both doses (NOT concomitantly).
Then take Tecfidera with a cup of applesauce (or more food).
2-4 weeks of this then attempt to withdraw. Some can, some cannot.
I will tell you all, the above has been magic in a number of our "ready to jump ship" patients. It's reduced our 30% down to less than 10% withdrawal. Perhaps our percentage of intolerant patients is higher than most, but Bob Lisak told me last night, this was his number as well.
