Dimethyl Fumarate
About Dimethyl Fumarate
Dimethyl Fumarate is a prescription medication used to manage relapsing forms of multiple sclerosis in adults. Its primary purpose is to decrease the frequency of physical flare-ups and help delay the progression of disability. By targeting inflammatory pathways, this medicine protects the central nervous system from ongoing nerve damage.
You will typically take this medication twice daily, and it is crucial to use it consistently at the same times every day to maintain steady levels in your body. While you can take it with or without food, taking your dose with a meal can help minimise temporary side effects like skin flushing. Incorporating stress-reduction techniques and moderate daily movement can also help you get the best results from your treatment.
While taking Dimethyl Fumarate, some people may experience mild side effects such as temporary flushing, nausea, or stomach discomfort. However, you should contact your doctor immediately if you experience serious symptoms like persistent fatigue, yellowing of the eyes, or signs of a severe infection. Your healthcare team is there to monitor your progress and ensure the treatment remains safe for you.
Before starting this medication, talk to your doctor if you have pre-existing liver damage, a low white blood cell count, or an active infection. Do not take this if you have had a severe allergic reaction to this medication or any of its ingredients in the past. Your doctor will help determine if this is the safest treatment option for your specific health profile.
This medicine can interact with alcohol, which may worsen stomach irritation, and smoking can affect how your body responds to the treatment. Additionally, certain medications that suppress your immune system can increase your risk of infection when combined with this therapy. If you are pregnant, breastfeeding, or planning to start a family, or if you are an older adult, consult your doctor to carefully weigh the benefits and risks.
Uses of Dimethyl Fumarate
Medicinal Benefits
This medicine brings several key health benefits:
- Supports long-term neurological health: Provide long-term protection for your nervous system, allowing you to maintain your daily physical function and independence.
- Reduces relapses: Helps reduce the frequency and severity of relapses, which helps you experience fewer disruptions to your routine and less pain or fatigue associated with sudden flare-ups.
- Slows disability progression: It helps slow down the accumulation of permanent physical disability, supporting your mobility and coordination.
- Reduces inflammation: Helps reduce the number of active inflammatory lesions in your brain and spinal cord, preserving overall neurological health.
Directions for Use
- Dimethyl Fumarate can be taken with or without food, but taking it with food may help reduce side effects like flushing or stomach upset.
- Take Dimethyl Fumarate twice a day, preferably at the same time each day, such as morning with breakfast and evening with dinner. However, follow the dosage and timing advised by the doctor.
- Swallow Dimethyl Fumarate as a whole with a glass of water.
- Do not crush, chew, or break it.
Storage
Side Effects of Dimethyl Fumarate
Common Side Effects (Usually mild)
- Redness, warmth, itching, or burning of the skin (flushing)
- Stomach pain or cramping
- Nausea, vomiting, or indigestion
- Diarrhoea or loose stools
Serious Side Effects (Consult your doctor right away)
- New or worsening weakness on one side of your body, severe clumsiness, vision changes, memory loss, or confusion (Signs of a rare but serious brain infection, PML-Progressive multifocal leukoencephalopathy)
- Yellowing of your skin or eyes, dark-colored urine, severe right-sided abdominal pain, or unusual fatigue (Signs of liver damage)
- Swelling of your face, lips, tongue, or throat, hives, or trouble breathing (Signs of a severe allergic reaction)
- Fever, persistent sore throat, or chills (Signs of a low white blood cell count or active infection)
Medicines Containing this Salt
View AllDrug Warnings
- Complete regular tests: Complete all recommended blood and urine tests before starting treatment and at regular intervals as directed by your doctor to monitor your liver function and white blood cell levels.
- Ask about aspirin: Discuss taking a non-enteric-coated aspirin (up to 325 mg) with your doctor before taking your dose, as this is sometimes recommended to help prevent skin flushing.
- Monitor for symptoms: Monitor yourself closely for any subtle changes in your thinking, memory, balance, or vision, and report these to your healthcare team immediately.
- Swallow the capsule whole: Ensure you do not chew, crush, or open the capsule, as breaking the protective coating can increase stomach-related side effects.
- Keep an updated medicine list: Keep an updated medicine list: Keep an up-to-date list of all medications, supplements, and herbal products you take, and share it with your pharmacist or doctor before starting any new treatments.
- PML monitoring: Your doctor may recommend JC virus (JCV) antibody testing and regular blood tests to help assess your risk of progressive multifocal leukoencephalopathy (PML). Discuss your individual risk with your neurologist.
- Allergy to fumaric acid esters (a group of medicines that includes Dimethyl Fumarate): Do not take this medicine if you are allergic to them, other fumaric acid esters, or any of the ingredients in the product. Consult your doctor if you have had an allergic reaction to these medicines before.
Drug Interactions
Inform your doctor if you are taking any of the following medicines, as they may interact.
- Other multiple sclerosis medicines (e.g., natalizumab, fingolimod): Do not use these medicines together with Dimethyl Fumarate unless advised by your neurologist, as combining disease-modifying therapies may increase the risk of serious infections and other side effects.
- Other immunosuppressants: Using them together may further weaken your immune system and increase the risk of infections.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorIt is unknown whether it is safe to consume alcohol with Dimethyl Fumarate. However, it is advisable not to take or limit alcohol as a precautionary measure.
Pregnancy
consult your doctorDo not take Dimethyl Fumarate if you are pregnant unless prescribed by the doctor.
Breast Feeding
consult your doctorDimethyl Fumarate is not recommended during lactation. Consult your doctor if you are breastfeeding.
Driving
cautionDimethyl Fumarate is unlikely to influence your ability to drive and use machines. However, do not drive or operate machinery if you experience any symptoms that affect your ability to concentrate and react. Seek medical attention if the symptoms persist longer.
Liver
consult your doctorDimethyl Fumarate to be taken with caution, especially if you have a history of liver diseases/conditions. Please consult your doctor to address any concerns.
Kidney
consult your doctorDimethyl Fumarate to be taken with caution, especially if you have a history of kidney diseases/conditions. Please consult your doctor if you have any concerns.
Children
unsafeDimethyl Fumarate should not be given to children as safety and effectiveness have not been established.
Habit Forming
Diet & Lifestyle Advise
- Manage flushing with meals: Take your dose alongside a meal or snack containing healthy proteins and fats, such as Greek yoghurt, cheese, or peanut butter, to help reduce the intensity of temporary skin flushing.
- Avoid heat triggers: High temperatures can temporarily worsen multiple sclerosis symptoms. Stay in air-conditioned environments during hot days, avoid very hot baths, and use cooling wraps if needed.
- Eat an anti-inflammatory diet: Focus on a balanced diet rich in leafy green vegetables, colourful berries, whole grains, and omega-3 fatty acids (found in fish like salmon or flaxseeds) to support overall brain and nerve health.
- Incorporate low-impact exercise: Gentle physical activities like swimming, walking, or adaptive yoga can help maintain muscle strength, balance, and flexibility without overexerting your body.
Special Advise
- Your doctor may advise complete blood count tests regularly.
- Your doctor may also prescribe blood tests to check your liver function before, during, and after therapy.
Patients Concern
Disease/Condition Glossary
Multiple sclerosis: Multiple sclerosis is a condition that affects the brain and spinal cord, resulting in symptoms such as problems with sensation, balance, vision, pain, impaired coordination, and fatigue. The immune system attacks the protective covering of the nerves (myelin) and causes disrupted communication between the brain and body due to nerve damage.
FAQs
Dimethyl Fumarate is used to treat people with clinically isolated syndrome, relapsing-remitting forms, and secondary progressive types of multiple sclerosis.
Dimethyl Fumarate stops the body's defence system from damaging the brain and spinal cord. Thereby delaying the worsening of multiple sclerosis. It also reduces inflammation and avoids nerve damage, thus helping treat the symptoms of multiple sclerosis.
Even if you feel better, keep taking Dimethyl Fumarate for as long as your doctor has prescribed it. Do not discontinue Dimethyl Fumarate without first consulting your doctor.
There is currently no cure for multiple sclerosis, but several treatments can help control the condition. Dimethyl Fumarate helps lower the number of relapses and slows down the progression of physical disabilities due to multiple sclerosis.
No, Dimethyl Fumarate is a medication prescribed by a doctor to treat specific medical conditions such as multiple sclerosis. Taking it on your own can result in adverse effects.
Dimethyl Fumarate may increase the risk of infections. It is advisable to obtain a complete blood count (CBC) before initiating treatment and monitor for infection during treatment and two months after discontinuation.
Dimethyl Fumarate may cause common side effects, including flushing, redness, itching, rash, nausea, vomiting, diarrhoea, stomach pain, and indigestion. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if these side effects persist or worsen.
While taking Dimethyl Fumarate, it is important to monitor parameters like white blood cell count, liver function, kidney function, and signs of infection.
Dimethyl Fumarate is generally not recommended for use during pregnancy and breastfeeding unless necessary. Before taking this medication, the risks and benefits should be discussed with your doctor.
There is no specific information indicating that Dimethyl Fumarate directly affects thyroid function. However, while taking this medication, it's important to monitor your overall health and report any unusual symptoms to your healthcare provider.
No, you should never crush, chew, or open the capsules. Doing so can destroy the special coating that protects your stomach and ensures the medicine is released correctly in your body. Talk to your doctor or pharmacist if you have trouble swallowing.
You should consult your healthcare provider before getting any vaccines. Live vaccines should generally be avoided during treatment, as your immune system may be less able to handle them. Talk to your doctor or pharmacist before scheduling any vaccinations.
Mild stomach irritation and diarrhoea are common, especially during the first few weeks of starting the treatment. Taking your doses with food can help ease these symptoms, but if they persist or become severe, talk to your doctor or pharmacist right away.
Your doctor will typically order blood tests before you start the medication and then every 6 to 12 months during treatment. These tests check your liver function and monitor your white blood cell levels to ensure the medicine is safe for you to continue. Talk to your doctor for a specific schedule.
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