Drug reference

diroximel fumarate

Immunomodulator (fumarate) · Immunomodulator

Immunomodulator (fumarate)Immunomodulator

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

AdalimumabSevereDatabaseDDInter
BaricitinibSevereDatabaseDDInter
CertolizumabSevereDatabaseDDInter
CladribineSevereDatabaseDDInter

Mechanism

Metabolized to monomethyl fumarate, the active form, which is an activator of nrf2 that mediates an antioxidative stress response. Appears to have multiple immunomodulatory effects.

Indications

relapsing-remitting mssecondary progressive ms in adults

Dosing

Adult: 7-day twice-daily initiation dosage followed by a double-dose twice-daily maintenance regimen

Side effects

Common

gi side effectscutaneous flushing

Serious

lymphopenia
pml
opportunistic infections (viral, fungal, bacterial)

Drug interactions

Adalimumab

Severe

Database

Drug interaction classified as: synergy

Source: DDInter

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

Dimethyl Fumarate

Severe

Database

Clinical effect not specified

Source: DDInter

Etanercept

Severe

Database

Clinical effect not specified

Source: DDInter

Fingolimod

Severe

Database

Clinical effect not specified

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

Stroke and TIA — secondary prevention

AHA · Neurology · 2021

Dyslipidaemia management

ICMR · Cardiology · 2023

Glomerular diseases

KDIGO · Nephrology · 2021

Dyslipidaemia management

ESC · Cardiology · 2019

Dyslipidaemia management

AHA · Cardiology · 2018

Other Immunomodulator (fumarate) drugs

monomethyl fumarate

0 brands

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Textbook-sourced·Sources: Goodman & Gilman 14e·Updated: 2026-05-10