Adalimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
Dimethyl fumarate
Immunosuppressant · Disease-modifying drug for Multiple Sclerosis
Also known as DMF
ImmunosuppressantDisease-modifying drug for Multiple Sclerosis
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Use only if essential.
FDA category + note
Top interactionssee all 12 →
- AdalimumabSevereDatabaseDDInter
- BaricitinibSevereDatabaseDDInter
- CertolizumabSevereDatabaseDDInter
- CladribineSevereDatabaseDDInter
Mechanism
Its exact mechanism of action is unknown, but it appears to activate the nuclear factor (erythroid-derived 2)-like 2 (NRF-2) transcriptional pathway. Activation of the NRF-2 pathway results in reduction of the oxidative stress that contributes to demyelination. It also appears to help protect the nerve cells from inflammation.
Indications
Active relapsing-remitting multiple sclerosisrelapsing-remitting mssecondary progressive ms in adults
Dosing
- Adult
- the dose of either drug. Tizanidine p. 1192 or dantrolene sodium p. 1417 are second-line options; benzodiazepines may be used as third-line therapy and may also be effective in treating nocturnal spasms. A 4-week trial of cannabis extract p. 1190 can be offered as adjunctive treatment for moderate to severe spasticity in multiple sclerosis if other pharmacological treatments are not effective.…
Contraindications
- Active infection
- Latent or active tuberculosis
Side effects
Common
FlushingNauseaDiarrheaAbdominal painIncreased hepatic enzymesEosinophiliagi side effectscutaneous flushing
Serious
- Significant lymphopenia
- Tuberculosis reactivation
- lymphopenia
- pml
- opportunistic infections (viral, fungal, bacterial)
Pregnancy & lactation
Pregnancy
Use only if essential.
Lactation
Avoid; no information available
Drug interactions
Baricitinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Certolizumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cladribine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Diroximel Fumarate
Severe
Database
Clinical effect not specified
Source: DDInter
Etanercept
Severe
Database
Clinical effect not specified
Source: DDInter
Fingolimod
Severe
Database
.
Source: DDInter
Golimumab
Severe
Database
Clinical effect not specified
Source: DDInter
Infliximab
Severe
Database
Clinical effect not specified
Source: DDInter
Leflunomide
Severe
Database
Clinical effect not specified
Source: DDInter
Lomitapide
Severe
Database
Clinical effect not specified
Source: DDInter
Measles Virus Vaccine Live Attenuated
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Other Immunosuppressant drugs
Ask House about Dimethyl fumarate
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, BNF·Verified: 2026-05-13 · House clinical team