Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Fumaric acid ester (prodrug of monomethyl fumarate)

Diroximel fumarate

Brand names: Vumerity

Diroximel fumarate is an oral disease-modifying therapy for relapsing-remitting multiple sclerosis, sharing the active metabolite of dimethyl fumarate but with a potentially improved gastrointestinal tolerability profile.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is rapidly converted to monomethyl fumarate, which is thought to activate the Nrf2 antioxidant pathway and modulate immune responses, reducing inflammatory and oxidative activity in the central nervous system.

Prescribing in practice

  • Monitor full blood count for lymphopenia, as prolonged severe lymphopenia is associated with progressive multifocal leukoencephalopathy (PML).
  • Gastrointestinal effects and flushing can occur and tend to be most prominent early in treatment.
  • Liver enzyme elevations can occur, so baseline and periodic liver function monitoring is recommended.

Monitoring

Check full blood count and liver function before and periodically during treatment, watching for persistent lymphopenia and new neurological features suggestive of PML.

Counselling the patient

  • Attend for regular blood tests to monitor white cells and liver function.
  • Flushing and gastrointestinal symptoms may occur, especially at first.
  • Report any new neurological symptoms such as weakness, confusion or changes in vision or speech.

Evidence & guidelines

Diroximel fumarate yields the same active metabolite as dimethyl fumarate, with comparative studies indicating improved gastrointestinal tolerability.

Reference: NICE TA evaluation; ABN MS-DMT; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways