Diroximel Fumarate

Indications

Diroximel Fumarate is used to treat relapsing forms of multiple sclerosis (MS) in adults. This includes clinically isolated syndrome, relapsing-remitting disease and active secondary progressive disease.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Nobody knows how diroximel fumarate works in multiple sclerosis. Its active metabolite, MMF, has been shown to activate the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway, in vitro and in vivo, in animals and humans. This pathway is involved in the cell's response to oxidative stress. MMF has also been identified as a nicotinic acid receptor agonist in vitro.

Pregnancy & Breastfeeding

We don't have enough data to say what risk Diroximel fumarate carries for development when it is used in pregnant women. The same is true of dimethyl fumarate, which has the same active metabolite as Diroximel. Nobody has measured whether diroximel fumarate or its metabolites (MMF, HES) pass into human milk. So the effects on a breastfed infant, and on milk production, are not known.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Blood tests prior to initiation of Diroximel Before treatment with Diroximel, get these done: a complete blood cell count (CBC), including the lymphocyte count, and serum aminotransferase, alkaline phosphatase and total bilirubin levels. Dosing information The starting dosage of Diroximel is 231 mg twice a day, taken orally. After 7 days, the dosage goes up to the maintenance dosage of 462 mg twice a day, taken orally (that is two 231 mg capsules each time). If a person can't tolerate the maintenance dosage, a temporary reduction to 231 mg twice a day may be considered. Within 4 weeks, the recommended dosage of 462 mg twice a day should be resumed. For patients who still can't tolerate the return to the maintenance dosage, stopping Diroximel should be considered. Non-enteric coated aspirin, up to a dose of 325 mg, taken 30 minutes before the Diroximel dose may reduce how often flushing happens or how severe it is. Administration instructions Swallow Diroximel capsules whole and intact. Don't crush or chew them, and don't sprinkle the contents on food. If you take the capsules with food, avoid a high-fat, high-calorie meal or snack. The meal or snack should contain no more than 700 calories and no more than 30 g fat.