Flushing might be unavoidable - seems like it's an agonist at the same receptor that causes niacin flush. (Strange if that turned out to be its MOA in MS and Niaspan worked for MS as well).
If so, flushing might be mitigated by similar tricks as with niacin. Although both niacin and fumarates agonize the a common receptor, some SE and benefits are different - niacin is not known to improve psoriasis, and fumarates are not known to improve lipid levels.
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