What is Dimethyl fumarate?
Adults with relapsing types of multiple sclerosis are treated with dimethyl fumarate (including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease).
Dimethyl fumarate uses
Multiple sclerosis relapsing types (MS)
Mechanism of action
Dimethyl fumarate’s mechanism of action in multiple sclerosis is not fully understood. It is believed to entail the breakdown of dimethyl fumarate to its active metabolite monomethyl fumarate (MMF). MMF activates the Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathway in response to oxidative stress. Additionally, MMF is a nicotinic acid receptor agonist, but the significance of this is unknown.
Dimethyl fumarate dosage
A normal starting dose is 120 mg twice daily for seven days. Your provider will next increase your dose to 240 mg twice daily by mouth.
Dimethyl fumarate administration
Capsules should be swallowed whole; do not chew or crush them. No capsules should be opened or the contents sprinkled over food. Your doctor will most likely begin you on a low dose of dimethyl fumarate and gradually raise it after seven days. Dimethyl fumarate may aid in the management of multiple sclerosis but does not cure it.
Dimethyl fumarate side effects
Dimethyl fumarate may have unintended consequences. Inform your doctor if any of the following symptoms are severe or persistent:
- The skin may be heated, red, itchy, or burn.
- Diarrhea
- Nausea
- Vomiting
- Heartburn
Certain adverse effects may be severe. If you suffer any of the following symptoms, immediately discontinue use of dimethyl fumarate and contact your doctor or seek emergency medical treatment:
- Swallowing or breathing difficulties
- Face, neck, tongue, lips, eyes, hands, feet, ankles, and lower legs swelling
- Hives
- Rash
- Itching
- Hoarseness
- Difficulties with vision
- Increasing weakness on one side of the body or clumsiness in the arms or legs
- Alterations in eyesight
- Cognitive, memory, or awareness alterations that result in perplexity and personality changes
- Excessive fatigue, appetite loss, pain in the upper right side of the stomach, dark urine, or yellowing of the skin or eyes
- A progressive weakening on one side of the body; clumsiness of the arms or legs; long-lasting changes in your thinking, memory, walking, balance, speech, vision, or strength; headaches; seizures; disorientation; or changes in personality
- On one side of the body or face, you may experience burning, tingling, itching, or skin sensitivity, followed by a severe rash or blisters several days later.
Interaction with other medications
Other medications, including prescription and over-the-counter medications, vitamins, and herbal supplements, may interact with dimethyl fumarate. Inform your doctor of all current medications and any new or discontinued medications.
Warnings/ instructions for use
Inform your doctor or pharmacist before taking dimethyl fumarate if you are allergic to it; to diroximel fumarate; or to monomethyl fumarate; or if you have any other allergies. This product may contain inactive chemicals that may cause allergic reactions or other adverse reactions. Consult your pharmacist for additional information.
Inform your doctor or pharmacist of your medical history, particularly of: low white blood cell counts, infections (including any present illness), or liver disease, prior to using this drug.
Storage
Capsules: Store between 15 and 30 degrees Celsius (59 and 86 degrees Fahrenheit); shield capsules from light; keep in original container.
Contraindications
Dimethyl fumarate is contraindicated in patients who have developed an allergic reaction to it or any of its excipients. Anaphylaxis and angioedema have been reported in association with dimethyl fumarate therapy, which may occur following the initial dose or at any time during treatment.
Pregnancy or lactation
Dimethyl fumarate is found in trace levels in breast milk. Due to the rapid elimination of dimethyl fumarate from the body, it is recommended that women who wish to breastfeed while taking this drug do so 4-5 hours after their dose to minimize the amount of medication the infant may receive. Consult your child’s healthcare professional if you feel the newborn is experiencing any symptoms such as flushing, vomiting, or diarrhea. Consult your healthcare physician with any breastfeeding-related concerns.
Dimethyl fumarate brand
Brand name: Tecfidera
