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Tecfidera (dimethyl fumarate) Disease Interactions

There are 7 disease interactions with Tecfidera (dimethyl fumarate):

Major

Immunosuppressive agents (applies to Tecfidera) infections

Major Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Serious and sometimes fatal infections have been reported in patients receiving immunosuppressive agents. Patients receiving immunosuppressants are at increased risk of developing bacterial, viral, fungal, and protozoal infections, and new or reactivated viral infections including opportunistic infections. Caution should be exercised when considering their use in patients with severe or chronic infections. It is recommended to interrupt therapy in patients who develop a new infection while undergoing treatment and to monitor these patients closely for any sign or symptom indicative of infection.

Major

Immunosuppressive agents (applies to Tecfidera) PML

Major Potential Hazard, Moderate plausibility. Applicable conditions: Immunodeficiency

Immunosuppressive agents may increase the risk of progressive multifocal leukoencephalopathy (PML). Certain agents are contraindicated in patients who have or have had PML. Patients receiving chronic immunosuppressant or immunomodulatory therapy or who have systemic medical conditions resulting in significantly compromised immune system function should not be treated with these agents. Healthcare professionals should monitor patients for any new sign or symptom suggestive of PML. Withhold therapy dosing immediately and perform an appropriate diagnostic evaluation at the first sign or symptom suggestive of PML.

Moderate

Dimethyl fumarate (applies to Tecfidera) liver

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

The use of dimethyl fumarate may cause liver injury. Elevations of hepatic transaminases were observed during controlled trials. It is recommended to obtain serum aminotransferase, alkaline phosphatase, and total bilirubin levels prior to treatment and during treatment, as clinically indicated. Caution is recommended when prescribing this agent in patients at risk for liver injury. Discontinue therapy if clinically significant liver injury induced by this agent is suspected.

Moderate

Dimethyl fumarate (applies to Tecfidera) lymphopenia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Lymphocytopenia

The use of dimethyl fumarate may decrease lymphocyte counts. It is recommended to obtain a CBC count before initiating treatment, 6 months after starting treatment, and then every 6 to 12 months thereafter, and as clinically indicated. Consider interrupting therapy in patients with lymphocyte counts less than 0.5 x 109/L persisting for more than six months and withhold treatment from patients with serious infections until resolution. Caution is recommended and the decisions about whether or not to restart therapy in these patients should be individualized based on clinical circumstances.

Moderate

Diroximel fumarate (applies to Tecfidera) liver injury

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Clinically significant cases of liver injury have been reported in patients treated with dimethyl fumarate (which has the same active metabolite as diroximel fumarate) in the postmarketing setting. Signs and symptoms of liver injury, including elevation of serum aminotransferases to greater than 5-fold the upper limit of normal and elevation of total bilirubin to greater than 2-fold the upper limit of normal have been observed. These abnormalities resolved upon treatment discontinuation. Caution and monitoring is advised in patients with liver impairment, as no studies have been conducted in these patients. Obtain serum aminotransferase, alkaline phosphatase (ALP), and total bilirubin levels prior and during treatment. Discontinue therapy if liver injury is suspected.

Moderate

Diroximel fumarate (applies to Tecfidera) lymphopenia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral, Lymphocytopenia

Diroximel fumarate may decrease lymphocyte counts up to 30% during the first year of treatment. Neither diroximel fumarate nor dimethyl fumarate (same active metabolite) have been studied in patients with preexisting low lymphocyte counts. Caution and monitoring is advised in patients with low lymphocyte counts. Consider withholding treatment from patients with serious infections until resolution.

Moderate

Diroximel fumarate (applies to Tecfidera) multiple sclerosis

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

There have been postmarketing reports of progressive multifocal leukoencephalopathy (PML), an opportunistic viral infection of the brain caused by the JC virus, in patients with MS treated with dimethyl fumarate (which has the same active metabolite as diroximel fumarate). Caution and monitoring is advised in patients with MS. Withhold treatment at the first sign or symptom of PML to perform an appropriate diagnosis.

Tecfidera (dimethyl fumarate) drug interactions

There are 313 drug interactions with Tecfidera (dimethyl fumarate)

Tecfidera (dimethyl fumarate) alcohol/food interactions

There is 1 alcohol/food interaction with Tecfidera (dimethyl fumarate)

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.