The first time I took it, I felt a little trepidation as I held that blue pill in my hand ready to swallow. I wondered if my face would immediately burst into red hot rashy hives. Fortunately, it did not. I took the pill and pretty much forgot about it until 5 1/2 hours later when I started feeling really hot.
Sure enough the "flushing and redness" side effect had hit. And boy did it ever hit. I looked like a red hot mess! After about an hour the effect had worn off and I was back to normal. The next day I only had a little trouble with the flushing, it seemed to be at about half the strength of the initial day. By the third day I didn't have any trouble at all.
Also to note, I didn't have any of the listed "stomach trouble" during the first week. I was really careful about taking the pills with a meal.
After the first seven days, the dosage doubles. I took the new pill, again wondering what would happen. It turns out that the higher dosage was definitely noticed by my body. I spent the initial day with some pretty intense stomach distress (TMI, sorry!), but by the second day I was better.
I also experienced the flushing and redness for about an hour the first day, but again, by the second day it was better.
Since that first day of the higher dosage I've hardly noticed any side effects. Yesterday however, I had a little stomach rumbling (but nothing too terrible) and then a few hours later my face burst into lovely shades of blotchy red that lasted about an hour. I don't know at this point why it hits some days and not others, but the side effects are supposed to get better with time.
Overall, the side effects have been tolerable.
The most noticeable obviously is the red faced flushing. I've been at home every time it's hit and my kids tell me, "Your face is really red!" If it hits when I'm out in public, I suppose I may have to explain why I look like Katniss Everdeen, the girl on fire.
Overall, I would say I've been happy with Tecfidera, red face and all.