Diroximel Fumarate

Diroximel Fumarate Brand Name

What is Diroximel Fumarate

Diroximel fumarate is an oral fumarate.

Like dimethyl fumarate, the drug is indicated for the treatment of adults with relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease.

Oral fumarates appear to have neuroprotective and anti-inflammatory properties; these actions can help delay disability and disease progression.

Diroximel fumarate has the same active metabolite (MMF) as dimethyl fumarate.

In clinical studies assessing safety in adult patients with relapsing-remitting multiple sclerosis (RRMS), approximately 700 patients were treated with diroximel fumarate and approximately 490 patients received more than 1 year of treatment with the drug.

The adverse reaction profile of diroximel fumarate was consistent with the experience in the placebo-controlled clinical trials with dimethyl fumarate.

Diroximel fumarate’s main advantage over dimethyl fumarate is better GI tolerability. Less patients discontinued treatment becuase of GI adverse effects with diroximel fumarate (0.8%) than dimethyl fumarate (4.8%).

Diroximel fumarate was FDA approved in October 2019

Indications

  • multiple sclerosis

For the treatment of relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. angioedema
  4. diarrhea
  5. dyspepsia
  6. elevated hepatic enzymes
  7. eosinophilia
  8. erythema
  9. flushing
  10. infection
  11. leukoencephalopathy
  12. leukopenia
  13. lymphopenia
  14. lymphopenia
  15. nausea
  16. progressive multifocal leukoencephalopathy
  17. proteinuria
  18. pruritus
  19. rash
  20. urticaria
  21. vomiting

Monitoring Parameters

  • CBC
  • LFTs
  • serum bilirubin

Contraindications

  • breast-feeding
  • hepatic disease
  • hepatotoxicity
  • immunosuppression
  • pregnancy
  • progressive multifocal leukoencephalopathy
  • renal failure
  • renal impairment

Interactions

  • Dimethyl Fumarate
  • Ethanol
  • Ocrelizumab
  • Ozanimod
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