Adults with different types of multiple sclerosis (MS; a condition in which the nerves do not function normally and people may experience weakness, numbness, loss of muscle coordination, problems with vision, speech, and bladder control) may take the medication diroximel fumarate to treat symptoms like:

• Solitary clinical syndrome (CIS; nerve symptom episodes that last at least 24 hours),
• Relapsing-remitting types (disease progression marked by intermittent symptom flare-ups), or
• Further developing forms (course of disease where relapses occur more often).

The drug diroximel fumarate belongs to the category of drugs known as Nrf2 activators. It functions by reducing inflammation and averting nerve damage that could result in multiple sclerosis symptoms.

To be taken orally, diroximel fumarate is available as a delayed-release capsule that delivers the medication in the intestine rather than the stomach, preventing stomach acids from breaking it down. Usually, it is taken twice a day. Take diroximel fumarate every day at roughly the same time. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Administer diroximel fumarate as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

You can take diroximel fumarate with or without food. Take care not to combine it with a meal or snack that is rich in fat or calories; the meal or snack must have fewer than 700 calories and no more than 30 grammes of fat.

Don’t consume alcoholic beverages while taking diroximel fumarate.

Do not split, chew, crush, or sprinkle the delayed-release capsules; instead, swallow each one whole.

To lessen the possibility of flushing (facial redness) during your treatment, you may take a non-enteric coated aspirin (325 mg or less) 30 minutes beforehand.

Most likely, your doctor will start you on a low dose of diroximel fumarate and gradually raise it over the course of 7 days.

Although it won’t cure multiple sclerosis, diroximel fumarate may help regulate the disease. If you feel fine, keep taking diroximel fumarate. Without consulting your doctor, do not discontinue taking diroximel fumarate.

For a copy of the manufacturer’s information for the patient, ask your chemist or doctor.

Ask your doctor or chemist for more details if you believe this drug should be used for something else.

Before taking diroximel fumarate,

• If you have any allergies, including to any of the substances in diroximel fumarate delayed-release capsules, Diamethyl fumarate (Tecfidera), other drugs, or food, notify your doctor right away. Get a list of the ingredients from your chemist.
• If you are taking dimethyl fumarate, let your doctor know (Tecfidera). If you are currently on this medicine, your doctor generally won’t advise you to use diroximel fumarate.
• Inform your doctor and chemist about any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now taking or intend to use. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Inform your doctor if you currently have or have ever had liver or renal illness, chicken pox, herpes zoster (shingles, a rash that can develop in people who have previously had chicken pox), a low white blood cell count, or any other medical conditions.
• If you are expecting a child, intend to get pregnant, or are a nursing mother, let your doctor know. Call your physician right away if you get pregnant while taking diroximel fumarate.
• Without consulting your doctor, avoid getting any immunisations.
• Diroximel fumarate may lower your resistance to bacterial, viral, and fungal infections and raise your chance of developing serious infections, so you should be aware of this. Inform your doctor if you frequently contract any kind of infection or if you already have or suspect you may have any kind of infection. This includes superficial infections (like small cuts or sores), transient infections (like herpes or cold sores), and persistent, chronic diseases. Call your doctor right away if you suffer any of the following signs or symptoms throughout or soon after receiving diroximel fumarate treatment: Weight loss, diarrhoea, stomach pain, frequent, urgent, or painful urination, chills, sweats, or fever, as well as other symptoms of infection such coughing, shortness of breath, muscle aches, and sores that are warm, red, or painful.

Keep eating normally unless your doctor instructs you otherwise.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Side effects from diroximel fumarate are possible. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Skin that is heated, red, itchy, or burning
• Abdominal pain
• Diarrhea
• Nausea
• Vomiting
• Heartburn
• Hair fall

Certain adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

• Difficulties breathing or swallowing
• Hives
• Rash
• Edoema of the hands, feet, ankles, lower legs, cheeks, neck, tongue, lips, and eyes
• Weakness on one side of the body, unsteadiness in your arms or legs, issues with your vision, modifications to your thinking and memory, disorientation, or changes in your personality
• Fatigue, loss of appetite, right stomach ache, dark urine, or yellowing of the skin or eyes
• Skin sensitivity, burning, tingling, or itching on one side of the body or face, followed a few days later by a severe rash or blisters

Further negative effects of diroximel fumarate are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling agency in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Before to starting your therapy and throughout it, your doctor might request a blood test to monitor how your body is responding to diroximel fumarate.

No one else should take your medication. Any queries you may have regarding prescription refills should be directed to your chemist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.