Vumerity (Diroximel Fumarate) - Oral

What Is Vumerity?

Vumerity (diroximel fumarate) is a prescription oral medication used to treat relapsing types of multiple sclerosis. This type of MS is characterized by periods when the condition gets worse (episodes).

It's not fully understood how Vumerity works. Once broken down in the body, the drug activates and reduces chemicals that increase inflammation, such as cytokines and other immune cells.

Vumerity is available as a delayed-release capsule to be taken by mouth (oral).

Drug Facts

Generic Name: Diroximel fumarate

Brand Name(s): Vumerity

Drug Availability: Prescription

Administration Route: Oral 

Therapeutic Classification: Immune modulator

Available Generically: No

Controlled Substance: No

Active Ingredient: Diroximel fumarate

Dosage Form(s): Capsule

What Is Vumerity Used For?

The Food and Drug Administration (FDA) approved Vumerity to treat relapsing forms of multiple sclerosis. This includes:

How to Take Vumerity

Always follow directions from your prescribing healthcare provider on how to take Vumerity.

You will need to have blood work done before you start treatment. This may include a complete blood cell count (CBC), including your lymphocyte count. Vumerity can decrease your lymphocytes. Having them checked before treatment will help make sure they do not drop too low.

You also might need to have tests that measure your liver function, such as blood aminotransferase, alkaline phosphatase, and total bilirubin levels. Vumerity can potentially cause damage to your liver. These tests help ensure that your liver is working properly.

Here are some tips for taking Vumerity:

  • Swallow the capsule whole and take it with food.
  • Do not take this medication with high-fat, high-calorie meals (700 calories or more and 30 grams of fat or more)
  • Avoid drinking alcohol when taking this medication.
  • Reddening of the face and chest (flushing) is a common side effect of this medication. Taking it with food can reduce the side effect. Taking aspirin 30 minutes before your dose can also reduce flushing; however, you should ask your healthcare provider if you can take aspirin as part of your treatment regimen.

Storage

Store the capsules in a cool, dry place at room temperature (between 68 F and 77 F).

Keep your medication out of areas with high heat or moisture. Do not store the medication in your bathroom or near the stove in your kitchen. Keeping medications in hot, humid environments can affect how well they work.

It is also important to keep your medications out of reach of children and pets to prevent accidental consumption.

Vumerity is a specialty medication. It is generally not readily available at a regular pharmacy. Contact your pharmacist to make sure that this medication will be available when you need it.

How Long Does Vumerity Take to Work?

How long Vumerity takes to work will depend on individual factors such as your weight, height, or age. Most people will be on the maintenance dose after seven days. If you are not feeling any improvements in your condition, contact the provider who prescribed it for you.

What Are the Side Effects of Vumerity?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or pharmacist. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Vumerity may include:

Severe Side Effects

Contact your healthcare provider immediately if you have serious side effects while you are taking Vumerity. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects of Vumerity can include:

Long-Term Side Effects

Once you stop taking Vumerity, you may experience the following:

  • Progressive multifocal leukoencephalopathy: While this infection is rare, it is very serious and can cause death.
  • Lymphopenia (low white blood cell counts): Having a low white blood cell count can increase your chance of getting an infection. Watch for symptoms such as fever, chills, or sore throat.

Report Side Effects

Vumerity may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Vumerity Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (delayed-release capsules):
    • For multiple sclerosis:
      • Adults—At first, 231 milligrams (mg) 2 times a day. After 7 days, your doctor will increase your dose to 462 mg 2 times a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

If you are a healthy adult, the dose of Vumerity will generally not change.

This drug should not be used in children. You should not take Vumerity if you are pregnant or breastfeeding. There is either not enough research or not enough quality research data to prove that Vumerity is safe in these situations.

Missed Dose

If you miss a dose of Vumerity, take it as soon as you remember. If it is close to the time when you'll take your next dose, skip the missed dose and only take your next scheduled dose. Do not take more than one dose at a time. If you continue to miss doses, your symptoms may not improve. 

Overdose: What Happens If I Take Too Much Vumerity?

If you take too much Vumerity, it will make side effects more likely to occur. There is no antidote to an overdose of the medication. If you take too much Vumerity, your symptoms will need to be treated. 

What Happens If I Overdose on Vumerity?

If you think you or someone else may have overdosed on Vumerity, call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Vumerity, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Do not use this medicine together with dimethyl fumarate (Tecfidera®). Using these medicines together may cause serious side effects.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

This medicine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection (including herpes). Avoid being near people who are sick or have infections while you are using this medicine. Wash your hands often. Tell your doctor if you have any kind of infection before you start using this medicine. Also tell your doctor if you have ever had an infection that would not go away or an infection that kept coming back.

Check with your doctor right away if you think you are getting an infection or if you get a fever, chills, cough, hoarseness, lower back or side pain, painful or difficult urination, burning or stinging of the skin, painful cold sores or blisters on the lips, nose, eyes, genitals, or trunk of body, chest pain, coughing or spitting up blood, sore throat, muscle aches, night sweats, trouble breathing, or unusual tiredness.

This medicine may increase your risk of developing a serious and rare brain infection called progressive multifocal leukoencephalopathy (PML). Check with your doctor right away if you have vision changes, loss of coordination, clumsiness, memory loss, difficulty speaking or understanding what others say, or weak legs.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause skin flushing. Tell your doctor right away if you have warmth, redness, itching, or a burning sensation in your face, neck, arms, or upper chest while using this medicine.

Do not drink alcohol while you are using this medicine.

Make sure your doctor know if you are pregnant or planning to become pregnant before using this medicine.

What Are Reasons I Shouldn’t Take Vumerity?

You should not take or be prescribed Vumerity if you have the following conditions:

  • A known allergic reaction to diroximel fumarate, dimethyl fumarate, or any of the ingredients
  • You are taking dimethyl fumarate (another medication used for multiple sclerosis)

What Other Medications Interact With Vumerity?

Vumerity should not be taken with Tecfidera (dimethyl fumarate), another medication used to treat relapsing forms of multiple sclerosis. Taking these drugs together may increase the chance of side effects.

Before starting treatment, tell your healthcare provider about all the prescription and over-the-counter (OTC) medications, vitamins, and herbal supplements that you take.

What Medications Are Similar?

Other medications that are similar to Vumerity and are used to treat relapsing forms of multiple sclerosis include:

  • Dimethyl fumarate
  • Bafiertam (monomethyl fumarate)

These drugs are prescribed to treat relapsing forms of multiple sclerosis. They should NOT be taken with Vumerity. Talk to your pharmacist or healthcare provider if you have questions.

Frequently Asked Questions

  • How expensive is Vumerity? Is there a way to get help paying for it?

    Vumerity is considered a specialty medication. It might be more expensive than other, more common prescription medications. The price will depend on your insurance.

    If you need help paying for it, the manufacturer may offer financial assistance. The website NeedyMeds can also help you find assistance programs. You can also talk to your provider or pharmacist about other financial assistance programs or nonprofits to help you pay for your medications.

  • How can I manage the side effects associated with Vumerity?

    Skin flushing is a common side effect of Vumerity. If you have the side effect, ask your provider if you can take 325 milligrams of non-enteric coated aspirin 30 minutes before your Vumerity dose. This can help reduce flushing.

  • What else should I do to manage my symptoms?

    To help you cope with multiple sclerosis, eat a nutritious diet, exercise your brain and body, and make sure you are well-rested. Talk to your provider about other ways that you can keep yourself healthy while you are having treatment. You may want to join a support group, either in-person or online, to connect with others going through many of the same things that you are living with MS.

How Can I Stay Healthy While Taking Vumerity?

To stay healthy while taking Vumerity, take your medication exactly as directed by your healthcare provider. While sticking to a consistent medication schedule can be hard, it's necessary to control your symptoms effectively.

In addition to taking your medication, it's important to practice self-care and learn to cope with your condition in other ways. Make sure to get plenty of sleep, stay hydrated, and eat a nutritious diet, as instructed by your healthcare provider. Look for ways to relieve stress, whether that be meditation, exercise, or confiding in family and friends.

MS can cause uncomfortable and even debilitating symptoms. It is important to communicate with your healthcare team about how you're feeling and how you're responding to the medication you've been prescribed. They may have other recommendations for your treatment plan to help you cope with symptoms.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to recognize and thank Chong Yol Gacasan Kim for contributing to this article.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Food and Drug Administration. Vumerity label.

  3. Hammer A, Waschbisch A, Kuhbandner K, et al. The NRF2 pathway as potential biomarker for dimethyl fumarate treatment in multiple sclerosis. Ann Clin Transl Neurol. 2018;5(6):668-676. doi:10.1002/acn3.553

  4. Cree BAC, Arnold DL, Chataway J, et al. Secondary progressive multiple sclerosis: new insights. Neurology. 2021;97(8):378-388. doi:10.1212/WNL.000000000001232

  5. National Center for Biotechnology Information. PubChem Compound Summary for CID 73330464, Diroximel fumarate

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  7. Food and Drug Administration. Bafiertam label.