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).

What Is Vumerity Used For?

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

• Clinically isolated syndrome: A type of relapse that can represent the onset of multiple sclerosis
• Relapsing-remitting disease: A type of relapse that recovers after the episode occurs
• Active secondary progressive disease: A type of relapse characterized by the worsening of your condition between relapses

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.

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:

• Flushing
• Abdominal pain
• Diarrhea
• Nausea
• Vomiting
• Rash

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:

• Anaphylaxis (a severe, potentially life-threatening allergic reaction) or angioedema (swelling under your skin)
• Progressive multifocal leukoencephalopathy (a brain infection that rapidly worsens and can have long-lasting effects)
• Serious infections (e.g., shingles (herpes zoster), West Nile virus, and other viral, fungal, or bacterial infections)
• Lymphopenia (reduced levels of blood cells called lymphocytes)
• Liver injury

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.
  

Dosage: How Much Vumerity Should I Take?

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. 

Precautions

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.

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.

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