Drug Interactions between diroximel fumarate and Rethymic
This report displays the potential drug interactions for the following 2 drugs:
- diroximel fumarate
- Rethymic (allogeneic processed thymus tissue)
Interactions between your drugs
diroximel fumarate allogeneic processed thymus tissue
Applies to: diroximel fumarate and Rethymic (allogeneic processed thymus tissue)
MONITOR CLOSELY: Prolonged use of immunosuppressants, particularly high-dose corticosteroids, after administration of allogenic thymocyte-depleted thymus tissue implant, may increase the risk of damage to the implant. However, Graft Versus Host Disease (GVHD) may be caused by or exacerbated by allogenic thymocyte-depleted thymus tissue implant in patients with congenital athymia and require treatment with systemic immunosuppressive therapy. In addition, patients with congenital athymia are at an increased risk of autologous GVHD (aGVHD), which may also require systemic immunosuppressive therapy, including treatment with corticosteroids such as methylprednisolone and prednisolone.
MANAGEMENT: The manufacturer advises that prolonged use of immunosuppressive therapies, including high-dose corticosteroids, should be avoided in patients who have received an allogenic thymocyte-depleted thymus tissue implant. Some authorities consider the use of high-dose corticosteroids in the period immediately after implant to be contraindicated and generally advise against the use of pulse corticosteroids (such as methylprednisolone 30 to 40 mg/kg/day for 3 days) post-implant due to the potential for permanent damage to the implant. If immunosuppressive therapy is required post-implant, patients should be closely monitored for signs of damage to the implant as well as adverse effects from the concomitant immunosuppressant(s). The concomitant immunosuppressant(s) should be weaned as soon as clinically possible.
References (2)
- (2021) "Product Information. Rethymic (allogeneic processed thymus tissue)." Enzyvant Therapeutics Inc., 1
- Gupton, S.E, McCarthy, E.A, Markert, M.L (2021) "Care of children with DiGeorge before and after cultured thymus tissue implantation" J Clin Immunol, 41, p. 896-905
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 (3)
- (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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