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Drug Interactions between Aplitest and diroximel fumarate

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tuberculin purified protein derivative diroximel fumarate

Applies to: Aplitest (tuberculin purified protein derivative) and diroximel fumarate

MONITOR: Immunosuppressed patients may have diminished response to diagnostic skin test antigens due to suppression of cell-mediated, delayed-type hypersensitivity. Falsely insignificant or false-negative results may occur in such patients, which may include those who have recently received or are receiving immunosuppressive agents, antilymphocyte globulins, alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (e.g., greater than or equal to 2 mg/kg/day or 20 mg/day of prednisone or equivalent for 14 consecutive days or more), or long-term topical or inhaled corticosteroids.

MANAGEMENT: Clinicians should be aware of the potential for falsely insignificant or false-negative results when administering diagnostic skin test antigens to patients treated with immunosuppressive agents.

References

  1. (2001) "Product Information. Candin (candida albicans extract)." Nielsen Biosciences Inc
  2. (2001) "Product Information. Histolyn-Cyl (histoplasmin)." ALK Laboratories Inc
  3. (2001) "Product Information. Spherulin (coccidioidin skin test)." ALK Laboratories Inc
  4. (2001) "Product Information. MSTA Mumps Skin Test Antigen (mumps skin test antigen)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Multitest CMI (skin test antigens, multiple)." Aventis Pharmaceuticals
  6. "Product Information. Tuberculin Tine Test (tuberculin purified protein derivative)." Connaught Laboratories Inc
View all 6 references

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Drug and food interactions

Moderate

diroximel fumarate food

Applies to: diroximel fumarate

GENERALLY AVOID: Food does not significantly affect the oral bioavailability of diroximel fumarate. Administration of diroximel fumarate with a high-fat, high-calorie (900 to 1000 calories; 50% from fat) meal did not affect the systemic exposure (AUC) of its active metabolite, monomethyl fumarate (MMF), but decreased its peak plasma concentration (Cmax) by 44% and prolonged the time to reach peak concentration (Tmax) from 2.5 to 7.0 hours relative to administration in the fasted state. In comparison, administration of diroximel fumarate with low-fat, low-calorie (350 to 400 calories; 10 to 15 g fat) and medium-fat, medium-calorie (650 to 700 calories; 25 to 30 g fat) meals decreased the MMF Cmax by approximately 12% and 25%, respectively, while also leaving the AUC unaffected.

GENERALLY AVOID: Coadministration of diroximel fumarate with ethanol may reduce the plasma concentrations of monomethyl fumarate (MMF). The mechanism has not been reported. Following coadministration with 240 mL of 5% v/v and 40% v/v ethanol, the mean Cmax of MMF was reduced by 9% and 21%, respectively, relative to coadministration with water. The AUC of MMF was not significantly altered, indicating that ethanol did not induce dose dumping.

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 containing no more than 700 calories and no more than 30 grams of fat. Taking diroximel fumarate with food may improve tolerability for patients experiencing flushing or gastrointestinal adverse reactions. The manufacturer also recommends avoiding concomitant use of diroximel fumarate with ethanol.

References

  1. (2022) "Product Information. Vumerity (diroximel fumarate)." Biogen Australia Pty Ltd
  2. (2022) "Product Information. Vumerity (diroximel fumarate)." Biogen Idec Ltd
  3. (2023) "Product Information. Vumerity (diroximel fumarate)." Biogen Idec Inc, SUPPL-9

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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