Diroximel Fumarate and alcohol

Ethanol may reduce the blood levels of the active medication in diroximel fumarate. You should avoid or limit the use of ethanol while being treated with diroximel fumarate. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration of diroximel fumarate with ethanol may reduce the plasma concentrations of monomethyl fumarate (MMF), the active metabolite of diroximel fumarate. The mechanism has not been reported. Following coadministration with 240 mL of 5% v/v and 40% v/v ethanol, the mean peak plasma concentration (Cmax) of MMF was reduced by 9% and 21%, respectively.

MANAGEMENT: The manufacturer recommends avoiding concomitant use of diroximel fumarate with ethanol.

Taking diroximel fumarate with high-fat, high-calorie meals or snacks may decrease the blood levels of diroximel fumarate in your body. Taking diroximel fumarate with food may help reduce flushing; however, meals or snacks should contain no more than 700 calories and no more than 30 grams of fat. In addition, you should avoid or limit the use of alcohol while being treated with diroximel fumarate. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Food does not significantly affect the oral bioavailability of diroximel fumarate. Administration of diroximel fumarate with a high-fat, high-calorie meal did not affect the systemic exposure (AUC) of its active metabolite, monomethyl fumarate (MMF), but the meal did decrease its peak plasma concentration (Cmax) by 44% and prolonged the time to reach peak concentration (Tmax) from 2.5 hours to 7.0 hours compared with the fasted state. In comparison, administration of diroximel fumarate with low-fat, low-calorie and medium-fat, medium-calorie meals decreased the MMF Cmax by approximately 12% and 25%, respectively. Low, medium, and high-fat meals did not affect the AUC of MMF following administration of diroximel fumarate.

GENERALLY AVOID: Coadministration of diroximel fumarate with ethanol may reduce the plasma concentrations of monomethyl fumarate (MMF), the active metabolite of diroximel fumarate. The mechanism has not been reported. Following coadministration with 240 mL of 5% v/v and 40% v/v ethanol, the mean peak plasma concentration (Cmax) of MMF was reduced by 9% and 21%, respectively.

MANAGEMENT: Diroximel fumarate may be taken with or without food; however, high-fat, high-calorie meals or snacks should be avoided. The manufacturer recommends meals or snacks with no more than 700 calories and no more than 30 grams of fat. Taking diroximel fumarate with food may help reduce flushing. The manufacturer recommends avoiding concomitant use of diroximel fumarate with ethanol.