Drug Interactions between diroximel fumarate and moxetumomab pasudotox
This report displays the potential drug interactions for the following 2 drugs:
- diroximel fumarate
- moxetumomab pasudotox
Interactions between your drugs
moxetumomab pasudotox diroximel fumarate
Applies to: moxetumomab pasudotox and diroximel fumarate
MONITOR: The use of fumaric acid esters in combination with medications that can cause nephrotoxicity (e.g., aminoglycosides, diuretics, nonsteroidal anti-inflammatory drugs, cyclosporine, lithium, methotrexate) may increase the potential for adverse renal reactions. In clinical trials in patients with multiple sclerosis treated with dimethyl fumarate, a fumaric acid ester that is converted to the active metabolite monomethyl fumarate, adverse events of proteinuria were reported at slightly higher frequencies than in patients receiving placebo. The clinical significance of these observations is unknown. Cases of Fanconi syndrome have been reported for a medicinal product containing dimethyl fumarate in combination with other fumaric acid esters. Renal toxicity, including tubular changes and/or interstitial fibrosis, has been observed in animal studies with dimethyl fumarate and diroximel fumarate.
MANAGEMENT: The use of fumaric acid esters in patients who receive concomitant treatment with potentially nephrotoxic agents, particularly for longer durations, has not been evaluated and should be approached with caution. Assessment of renal function (e.g., serum creatinine, blood urea nitrogen, urinalysis) is recommended prior to initiating treatment with fumaric acid esters and as clinically indicated during treatment.
References
- (2022) "Product Information. Vumerity (diroximel fumarate)." Biogen Australia Pty Ltd
- (2023) "Product Information. Tecfidera (dimethyl fumarate)." Biogen Idec Inc, SUPPL-29
- (2022) "Product Information. Tecfidera (dimethyl fumarate)." Biogen Idec Ltd
- (2022) "Product Information. Skilarence (dimethyl fumarate)." Almirall Ltd
- (2022) "Product Information. Vumerity (diroximel fumarate)." Biogen Idec Ltd
- (2023) "Product Information. Vumerity (diroximel fumarate)." Biogen Idec Inc, SUPPL-9
- (2022) "Product Information. Furatec (dimethyl fumarate)." Pharmacor Pty Ltd, 03
Drug and food interactions
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
- (2022) "Product Information. Vumerity (diroximel fumarate)." Biogen Australia Pty Ltd
- (2022) "Product Information. Vumerity (diroximel fumarate)." Biogen Idec Ltd
- (2023) "Product Information. Vumerity (diroximel fumarate)." Biogen Idec Inc, SUPPL-9
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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