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diroximel fumarate

Brand Name :

Vumerity

Synonyms :

diroximel fumarate

Class :

Multiple Sclerosis Treatments, Immunomodulators

DRUG INTERACTION

diroximel fumarate

&

rimiterol
olanzapine/fluoxetine
normethadone/hydroxyephedrine
myrtol
moxonidine
propylhexedrine
sodium hypochlorite solution
sodium chloride/sodium citrate
Hepatitis B Vaccine (Recombinant [Adjuvanted])
Hepatitis B Vaccine (Recombinant)
aceclofenac and serratiopeptidase
levosulpiride
niaprazine
tromantadine
trimetazidine
vinburnine
mizoribine
molgramostim
mosapride
eugenol
tolperisone
etamsylate
etynodiol
mizolastine
metenolone
reproterol
rebamipide
mephenoxalone
metandienone
furosemide/spironolactone
hydroxycarbamide
tenonitrozole
fenoverine
fenquizone
tiapride
tibolone
furazolidone
furosemide & amiloride
fosfestrol
fluclorolone
flubendazole
tertatolol
tetracosactide
tetryzoline
tolciclate
trapidil
troxipide
temoporfin
telbivudine
teprenone
hexamidine
mebhydrolin
mepartricin
fencamfamin
medazepam
theodrenaline
thiamazole
thiocolchicoside
psilocybin
veralipride
pyritinol
opipramol
oprelvekin
betamethasone + gentamicin
betamethasone + neomycin
betamethasone + salicylic acid
oxedrine
bopindolol
orgotein (investigational)
oxaceprol
ormeloxifene
bevantolol
bifemelane
clebopride
demoxytocin
cicletanine
cefsulodin
chlortalidon
sisomicin
somatrem
carbazochrome
caroverine
cathine
ipriflavone
isepamicin
silymarin
simethicone
sermorelin
diloxanide
dimethindene
diosmin/hesperidin
calamine
canrenone
captodiame
imidapril
cefetamet
cefodizime
cefoperazone + sulbactam
ivermectin + albendazole
serrapeptase
bromisoval
beraprost
pridinol
proglumide
bamipine
barnidipine
bamifylline
benzbromarone
betamethasone/fusidic acid
para-chlorophenol
pantethine
nomifensine
pemoline
parnaparin
pentolinium
nialamide
novobiocin
nicergoline
octocrylene
octisalate
oftasceine
oxolamine
oxyphencyclimine
penfluridol
pentoxyverine
phenoxymethylpenicillin
picloxydine
pilsicainide hydrochloride
piperazine
pirarubicin
policresulen
prifinium bromide
prethcamide
pristinamycin
pirenzepine
piribedil
pimethixene
pargyline
phosphatidyl choline
phthalylsulfathiazole
phytomenadione
pranlukast
pinazepam
oxyphenonium
noxytiolin
periciazine
pethidine
phenindamine
histidine
isoleucine
proline
lauric acid
lymecycline
hypromellose
abiraterone acetate and niraparib
ichthammol
levamisole
naftazone
nefopam
oxprenolol
oxybuprocaine
elranatamab-bcmm
lapyrium
isoaminile
iotrolan
mazindol
masoprocol
lypressin
meradimate
molsidomine
monobenzone
mequinol/gluconolactone/ lactobionic acid/ arbutin
medifoxamine
mebutamate
metergoline
methantheline
methdilazine
metocurine
micronomicin
metaraminol
mephenesin
menadione
medrysone
metixene
levobetaxolol
guaiacol glycerol ether
eucalyptol
sodium tetradecyl sulfate
sugammadex
carbetocin
certoparin
chlorcyclizine/pseudoephedrine
cephapirin
indecainide
iobitridol
iomeprol
chlorphenesin
msud analog
msud maxamum
iceland moss
glutethimide
hexachlorophene
haloprogin
deferoxamine
ethchlorvynol
dexpanthenol topical
etilefrine
deslanoside
carbocromen
diazolidinylurea
dibenzepin
etofamide
guanoxan
halazepam
guanadrel sulfate
dapiprazole
soapwort
debrisoquine
l-tryptophan
chlormerodrin
chlorquinaldol
cetrimonium
carbocisteine
chlorcyclizine/codeine
technetium Tc-99m tetrofosmin
technetium Tc-99m disofenin
technetium Tc-99m gluceptate
technetium Tc-99m labeled red blood cells
amylmetacresol/dextromethorphan hydrobromide
anileridine phosphate
pyrethrins
pyrantel pamoate
quinagolide
spiramycin
standard hyperkalemic cardioplegia solution
technetium tc-99m mertiatide
technetium tc-99m medronate
bemotrizinol / bisoctrizole
benfotiamine
bemotrizinol + titanium dioxide + zinc oxide
technetium Tc-99m oxidronate
technetium Tc-99m pentetate
technetium Tc-99m pyrophosphate
benziodarone
octinoxate/bisoctrizole
bicisate dihydrochloride
technetium Tc-99m bicisate
norelgestromin/ethinyl estradiol
norgestimate/ethinyl estradiol
ximelagatran (investigational)
xamoterol
trioxsalen
poly-urea urethane
rilmenidine
pemirolast
oxitriptan
beclomethasone, intranasal
thimerosal
camphor gel
camphor
mumps virus vaccine, live
rubella virus vaccine, live
aluminum chloride (dental)
alum irrigation
framycetin, phenylephrine, and gramicidin
ombitasvir, paritaprevir, ritonavir, and dasabuvir
olipudase alfa
etonogestrel/ethinyl estradiol
mycophenolate
fluoroestradiol F 18
donor organ cardioplegia solution
fluciclovine F 18
fusidic acid (ophthalmic)
fusidic acid and hydrocortisone
framycetin, dexamethasone, and gramicidin
fludeoxyglucose F-18
fluorouracil/salicylic acid
indium In-111 oxyquinoline
indium In-111 pentetreotide
indium In-111 capromab pendetide
lusutrombopag
mitomycin (ophthalmic)
mifepristone and misoprostol
minoxidil (systemic)
methyl aminolevulinate (topical)
methyl folate, methylcobalamin, and acetylcysteine
ciclesonide/formoterol/tiotropium
nedocromil (Oral Inhalation)
batefenterol (Investigational)
neostigmine and glycopyrrolate
nepafenac ophthalmic
netupitant/palonosetron
meperidine and promethazine
mepivacaine and levonordefrin
maltodextrin
medical cannabis
medium chain triglycerides
mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
moxifloxacin ophthalmic
neomycin/fluocinolone
nadroparin
iodine I-125 iothalamate
amikacin liposome (oral inhalation)
bupivacaine liposome
natamycin
lopinavir and ritonavir
lysine
macitentan and tadalafil
mitomycin pyelocalyceal
moclobemide
mometasone and indacaterol
efinaconazole
blue-green algae
indocyanine green
follitropin beta
lumasiran
glycerin/lidocaine
edrophonium/atropine
indigo carmine
lutropin alfa
instant glucose/intravenous dextrose
iobenguane I-123
ixekizumab
isosulfan blue dye
levofloxacin ophthalmic
levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
ethinyl estradiol/levonorgestrel transdermal
hydroquinone
hydroxypropyl methylcellulose
icodextrin
lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
iodinated I 125 albumin
iodinated I 131 albumin
lipid emulsion (plant oil-based)
levonorgestrel intrauterine
levonorgestrel oral/ethinyl estradiol
lactic acid and sodium-PCA
lactated Ringer solution
ketotifen (systemic)
lanolin
leuprolide and norethindrone
levodopa and benserazide
gonadorelin acetate
hemodialysis solutions
nirsevimab-alip
gentian violet
gallium ga-68 dotatate
fusidic acid and betamethasone
gallium citrate Ga-67
gadopentetate dimeglumine
gadofosveset
follitropin delta
follitropin alfa and lutropin alfa
follitropin alfa
rocatinlimab
grass pollens allergen extract
flotufolastat F18
fluorescein ophthalmic
barium
balanced salt solution
air polymer type A intrauterine device
clodronate
bentoquatam
clobetasone
alfacalcidol
citric acid/glucono-delta-lactone/magnesium carbonate
benzoin
desirudin
immune globulin IV (IGIV)
dequalinium
pseudoephedrine/desloratadine
clofedanol
cyproterone and ethinyl estradiol
dextranomer and hyaluronic acid or derivatives
diatrizoate meglumine and diatrizoate sodium
glucosamine sulfate, chondroitin sulfate and Msm
squill
gotu kola
blessed thistle
bitter melon
apraclonidine
chlophedianol/dexbrompheniramine/pseudoephedrine
wild jujube
chitosan
cilazapril/hydrochlorothiazide
dexbrompheniramine and phenylephrine
diethylene triamine penta-acetic acid
dexchlorpheniramine and pseudoephedrine
lily of the valley
diflucortolone
corydalis
lemon balm
MSM
calcium polystyrene sulfonate
caprylidene
peppermint oil
efavirenz/lamivudine/tenofovir DF
emtricitabine/tenofovir DF /efavirenz
dutasteride/tamsulosin
milk thistle
centaury
horseweed
lycopus
agrimony
alfalfa
kava
cetrorelix
cetylpyridinium
chlophedianol and dexbrompheniramine
betahistine
choline C-11
boric acid vaginal suppository
aluminum acetate
aluminum chloride hexahydrate
14-C urea breath test
absorbable collagen
valoctocogene roxaparvovec-rvox
amlodipine and celecoxib
aspirin and omeprazole
azilsartan and chlorthalidone
landiolol (Pending FDA approval)
isosorbide dinitrate/hydralazine
losartan/hydrochorothiazide
udenafil
dextromethorphan/quinidine
onasemnogene abeparvovec
orphenadrine/aspirin/caffeine
trace elements
sodium phenylbutyrate/ taurursodiol
fish oil triglycerides
infant formula
glutamine
chloroquine phosphate
afatinib
quinidine gluconate
methylergonovine
prothrombin complex concentrate, human
BCG intravesical live
capivasertib
cedazuridine
carbonyl iron
iron dextran complex
lovotibeglogene autotemcel (FDA Approval Pending)
sodium benzoate/sodium phenylacetate
mineral oil otic
zolmitriptan transdermal
midazolam intranasal
fosinopril/hydrochlorothiazide
caplacizumab
arginine
sodium phenylbutyrate
meloxicam/rizatriptan
manganese
acetaminophen/pamabrom/pyridoxine
varicella zoster immune globulin, human
amitriptyline/perphenazine
narsoplimab (Pending FDA Approval)
amlodipine/perindopril
imiglucerase
canagliflozin/metformin
tafamidis meglumine
somatrogon-ghla
glimepiride/rosiglitazone
becaplermin
lithium
loxapine inhaled
nicotine transdermal
tixagevimab and cilgavimab (Investigational)
muromonab CD3
ansuvimab
coal tar bath products
fibrin sealant
arimoclomol (FDA Approval Pending)
varenicline intranasal
aducanumab
oxycodone/naloxone
ritlecitinib
sodium polystyrene sulfonate
calcipotriene/betamethasone
calcium hydroxylapatite
cantharidin topical
doxepin cream
clocortolone
formaldehyde topical
sodium sulfide topical
collagenase
selegiline transdermal
foscarbidopa/foslevodopa (FDA approval pending)
saxagliptin/metformin
linagliptin/metformin
linzagolix (FDA approval pending)
efgartigimod/hyaluronidase SC
elamipretide (Pending FDA approval)
rozanolixizumab
diazoxide
glimepiride/pioglitazone
cipaglucosidase alfa
dihydroergotamine intranasal
delandistrogene moxeparvovec
beremagene geperpavec
hyaluronic acid and derivatives
hyaluronic acid, non-animal stabilized
eplontersen (FDA Approval Pending)
nitric oxide gas
sodium phenylbutyrate and taurursodiol
treprostinil SC
viltolarsen
albuterol/ipratropium
budesonide inhaled
budesonide rectal
palovarotene (FDA Approval Pending)
sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
amino acids mixture
aminobenzoate potassium
elivaldogene autotemcel
naproxen and sumatriptan
sumatriptan intranasal
alglucerase
metformin/rosiglitazone
ertugliflozin/metformin
elosulfase alfa
calcium carbonate/magnesium hydroxide
starch suppository
abicipar pegol (FDA Approval Pending)
riboflavin 5′-phosphate ophthalmic
povidone ophthalmic
glycerin oropharyngeal
dimethicone topical
menthol topical, dimethicone topical
pramoxine topical, menthol topical and dimethicone topical
phosphorated carbohydrate
brilliant blue G ophthalmic
brolucizumab intravitreal
purified water, ophthalmic
hydroxyethyl cellulose ophthalmic
ranibizumab intravitreal implant
sodium chloride hypertonic, ophthalmic 
cetirizine ophthalmic
phentolamine ophthalmic (FDA Approval Pending)
ganciclovir ophthalmic
triamcinolone intravitreal
ocriplasmin intravitreal
atoltivimab/maftivimab/odesivimab
pegcetacoplan intravitreal
triamcinolone acetonide extended-release injectable suspension
tobramycin/loteprednol ophthalmic
2-octyl cyanoacrylate
vitamins A & D topical
diphenhydramine/allantoin topical
pyrethrins/piperonyl butoxide
lodoxamide ophthalmic
obeticholic acid
fluocinolone intravitreal implant
sincalide
linaclotide
nedocromil ophthalmic
cysteamine ophthalmic
avacincaptad pegol intravitreal
azelastine ophthalmic
bacitracin ophthalmic
propylene glycol ophthalmic
rimexolone ophthalmic
metoclopramide intranasal
mirikizumab (FDA approval pending)
netarsudil ophthalmic
cenegermin
dexamethasone ophthalmic insert
prednisolone ophthalmic
phenylephrine and cocoa butter rectal
phenylephrine and witch hazel topical
phenylephrine, pramoxine, glycerin and petrolatum rectal
bisacodyl rectal
aluminum hydroxide/magnesium carbonate
aluminum hydroxide/magnesium hydroxide
hyoscyamine spray
methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
phenylephrine
chlorophyll
castor oil
cholic acid
phenol oropharyngeal
articaine/epinephrine
antithymocyte globulin equine
aluminum hydroxide/magnesium trisilicate
methenamine/hyoscyamine
hydrocortisone topical/pramoxine topical
sodium fluoride topical
mesna
C1 esterase inhibitor recombinant
menthol and pectin
menthol oropharyngeal
pectin oropharyngeal
gepirone
Goldenseal
polyethylene glycol and electrolytes
polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
brompheniramine/pseudoephedrine/dextromethorphan
brompheniramine phenylephrine
acetaminophen/doxylamine/phenylephrine
doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
acetaminophen/doxylamine/dextromethorphan
acetaminophen/doxylamine/dextromethorphan/phenylephrine
eslicarbazepine
fluticasone and salmeterol
codeine, acetaminophen, butalbital and caffeine
codeine, chlorpheniramine and phenylephrine
iodine
povidone iodine
butalbital/aspirin/caffeine/codeine
polyethylene glycol 400/propylene glycol ophthalmic 
pegvaliase
amivantamab
iopamidol
codeine and pseudoephedrine
emtricitabine, rilpivirine, tenofovir DF
penicillin G aqueous
miconazole topical
miconazole vaginal
ciprofloxacin inhaled (Pending FDA approval)
ceftazidime/avibactam
ceftolozane/tazobactam
aztreonam inhalation
amphotericin B cholesteryl sulfate
miconazole oral
elvitegravir/cobicistat/emtricitabine/tenofovir DF
isavuconazonium sulfate
dapivirine intravaginal (FDA Approval Pending)
lamivudine/raltegravir
codeine/triprolidine/pseudoephedrine
cadexomer iodine
brompheniramine/pseudoephedrine
codeine/acetaminophen
codeine/guaifenesin
beclomethasone inhaled
epoetin beta/methoxy polyethylene glycol
voreloxin(Orphan Drug)
rociletinib
pitcher plant
phosphatidylserine
telotristat ethyl
copper CU 64 dotatate
urea topical
exenatide subdermal implant
asenapine transdermal
ethiodized oil
urea oral
miglustat
acalisib(Investigational)
acetophenazine
guggul
aceneuramic acid
mestranol/norethindrone
reishi
lactitol
vonoprazan fumarate
motherwort
silver nitrate
salicylic acid/sulfur shampoo
salicylic acid topical
ketorolac ophthalmic
ketoconazole topical
Japanese encephalitis virus vaccine
dibucaine topical ointment
ketorolac intranasal
ketorolac/phenylephrine ophthalmic
rotavirus oral vaccine, live
guarana
hops
krill oil
salicylic acid/coal tar shampoo
sufentanil SL
pancrelipase
passion flower
pepdite one plus
nivolumab and relatlimab
relatlimab (Pending FDA Approval)
benzalkonium chloride/benzocaine
ketotifen, drug-eluting contact lens
calcitriol topical
oxymetazoline topical
alclometasone topical
capsaicin topical
diclofenac/misoprostol
diclofenac ophthalmic
diclofenac topical
pramoxine/calamine topical
veverimer
tolazoline
olopatadine ophthalmic
lutetium lu 177-dota-tate
lutetium lu 177 vipivotide tetraxetan
strontium 89 chloride
interferon alfa n3
lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
samarium sm 153 lexidronam
cytomegalovirus immune globulin (CMV IG)
antithymocyte globulin rabbit
inolimomab (Pending FDA Approval)
olopatadine intranasal
olopatadine intranasal/mometasone, intranasal
benzocaine/butamben/tetracaine topical
antipyrine/benzocaine/phenylephrine
dyclonine/menthol
surufatinib
fruquintinib
tepotinib 
dostarlimab
hepatitis B immune globulin (HBIG)
remestemcel-L
benzocaine/menthol oropharyngeal
interferon beta 1b
tetracaine/oxymetazoline intranasal
benzocaine oropharyngeal
benzalkonium chloride/menthol/petrolatum topical
inamrinone
alpha 1 proteinase inhibitor
potassium bicarbonate/potassium citrate
potassium phosphate/sodium acid phosphate
asparaginase Erwinia chrysanthemi recombinant
motixafortide
pegloticase
etesevimab
Rho(D) immune globulin
tetanus immune globulin (TIG)
reltecimod (pending FDA approval)
avasopasem
trimethoprim/polymyxin B ophthalmic
naphazoline ophthalmic
sulfacetamide topical
sirolimus intravitreal (pending FDA approval)
sirolimus protein bound
sirolimus topical
glycopyrronium tosylate topical
sofpironium
olmesartan, amlodipine and hydrochlorothiazide
dovitinib (Pending FDA Approval)
epinephrine inhaled
quizartinib (Pending FDA Approval)
ranibizumab intravitreal injection
sodium hyaluronate
bacitracin and lidocaine topical
brimonidine topical
benzoyl peroxide and tretinoin topical
talquetamab
betrixaban
acetaminophen/caffeine/pyrilamine
fentanyl transmucosal
bacitracin topical
buprenorphine,long-acting injection
buprenorphine buccal
nalmefene intranasal
sulbactam/durlobactam
metronidazole topical 
daratumumab/hyaluronidase
glofitamab
rituximab-hyaluronidase
drospirenone/ethinyl estradiol/levomefolate
loncastuximab tesirine
ingenol mebutate topical
momelotinib
trastuzumab/deruxtecan
trastuzumab/hyaluronidase
trastuzumab duocarmazine
lifileucel
umbralisib
eflornithine/sulindac
cytarabine/daunorubicin liposomal
doxorubicin liposomal
epcoritamab
lanadelumab  
esomeprazole/naproxen 
terbinafine topical
ravulizumab
clotrimazole topical
choline magnesium trisalicylate
tacrolimus ointment
mechlorethamine topical
donislecel
pozelimab (Pending FDA Approval)
human rabies immune globulin (HRIG)
melphalan flufenamide
sintilimab (Pending FDA Approval)
oportuzumab monatox (Pending FDA Approval)
sotorasib
irinotecan liposomal
sulfur topical
silver sulfadiazine
capsaicin transdermal
sutimlimab
tretinoin topical
acetaminophen rectal
menthol topical
naftifine
oatmeal, colloidal topical
oxiconazole
methylsalicylate/menthol topical
C1 inhibitor human
lifitegrast ophthalmic
prednisolone/sulfacetamide ophthalmic
mannitol inhalation
ofloxacin otic
petrolatum & mineral oil topical
clascoterone topical
gefapixant (Pending FDA Approval)
colesevelam
technetium Tc 99m succimer
nebivolol/valsartan
ciprofloxacin/fluocinolone acetonide, otic
finafloxacin otic
magnesium hydroxide/mineral oil
phenylephrine/mineral oil/petrolatum rectal
carbamide peroxide oral
atropine ophthalmic
sodium sulfacetamide/sulfur
sulfacetamide ophthalmic
lucinactant
benzonatate
besifloxacin ophthalmic
benzhydrocodone/acetaminophen
beractant
trimagnesium citrate anhydrous
vitamin b2
carbamide peroxide otic
mineral oil topical
ethyl alcohol intranasal
boric acid/alcohol otic
absorbable gelatin compressed sponge, USP
absorbable gelatin sponge, USP
vincristine liposomal
technetium Tc 99m albumin aggregated injection
metaproterenol
budesonide inhaled/formoterol/glycopyrrolate inhaled
epinephrine racemic
umeclidinium bromide/vilanterol inhaled
indacaterol, inhaled/glycopyrrolate inhaled
betaine  
laronidase 
estrogens esterified/methyltestosterone            
cerliponase alfa
ertugliflozin/sitagliptin
hawthorn
shepherd’s purse
thiamine
naphazoline/glycerin ophthalmic
oxymetazoline ophthalmic
dorzolamide
dexamethasone intraocular
dexamethasone/ciprofloxacin
dexamethasone ophthalmic
metipranolol ophthalmic
timolol ophthalmic
boron
fezolinetant
pegunigalsidase alfa-iwxj
biotin
pantothenic acid
silicon
sodium acid phosphate
hypochlorous acid topical
methenamine/sodium acid phosphate
aviptadil 
bremelanotide
glucagon intranasal
metformin and repaglinide
bai ji
pau d’arco
juzentaihoto
mistletoe
quercetin
rosemary
sheng di huang
chasteberry
maitake
grapefruit
lentinan
juniper
nettle
parsley
rose hips
tongkat ali
horny goat weed
damiana
yohimbe
insulin NPH
aprocitentan
noni Juice
sodium iodide I-131
green tea
sea cucumber
wheat germ extract
fenofibrate micronized 
rogisen
danshen
lutein
witch hazel
dextroamphetamine transdermal
amphetamine/dextroamphetamine
hoodia
kolanut
boswellia
opuntia ficus indica
lavender
nadh
tea tree oil
metformin/sitagliptin 
dapagliflozin/ metformin/saxagliptin  
antihemophilic factor recombinant
inclisiran
bempedoic acid/ezetimibe
volanesorsen
omega 3 carboxylic acids
pericyazine
levomepromazine (methotrimeprazine)
betaxolol ophthalmic
respiratory syncytial virus vaccine, adjuvanted
phenylephrine hydrochloride and tropicamide ophthalmic
alirocumab
neomycin/polymyxin B/gramicidin ophthalmic
factor IX
gentamicin topical
ansofaxine (Pending FDA Approval)
zuranolone
factor IX, recombinant
factor IX complex
factor XIII A-subunit, recombinant
factor X, human
mesalamine rectal
etrasimod
anti-inhibitor coagulant complex
factor IX, recombinant/albumin fusion protein
fibrinogen, human
aminocaproic acid
metyrosine
nonoxynol-9 vaginal
progesterone intravaginal gel
ipecac syrup
botulinum antitoxin, heptavalent
pentetate calcium trisodium
crotalidae polyvalent immune FAB (ovine)
dehydrated alcohol injection
gold sodium thiomalate (Discontinued)
lactic acid/citric acid/potassium bitartrate vaginal
von Willebrand factor, recombinant
luspatercept
digoxin immune FAB (Antidote)
crotalidae immune FAB (equine)
magnesium (Antidote)
pyridoxine (Antidote)
edetate calcium disodium
albumin IV
nitroglycerin sublingual
obiltoxaximab
anthrax immune globulin
nitroglycerin topical
dextrose
nesiritide
estradiol vaginal
bazedoxifene/conjugated estrogens
botulism immune globulin iv
amoxicillin/omeprazole/rifabutin
synthetic human angiotensin II
nitroglycerin IV
nitroglycerin translingual
nitroprusside sodium
tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
sodium citrate/citric acid
pemetrexate
methicillin
plasminogen 
acai
american ginseng
cordyceps
tramadol/acetaminophen
belladonna alkaloids/phenobarbital
erythromycin topical/benzoyl peroxide
glucosamine sulfate
panax ginseng (suppl/herb)
tolnaftate
sulopenem etzadroxil/probenecid
sulfur hexafluoride
sotrovimab
arbaclofen
rifampin/isoniazid
clindamycin /tretinoin topical
benzoyl peroxide/clindamycin topical
apremilast
antivenins, centuroides (scorpion)
bamlanivimab and etesevimab
vilobelimab
gadobenate
pentosan polysulfate sodium
methylsalicylate/menthol/camphor topical
antivenin, black widow spider
benzoyl peroxide and hydrocortisone
clindamycin topical
isometheptene, dichloralphenazone and acetaminophen
acetaminophen and phenyltoloxamine
erythromycin topical
erythromycin ophthalmic
alpha hydroxy acids, topical
buprenorphine transdermal
butalbital/acetaminophen/caffeine
buprenorphine/samidorphan
buprenorphine subdermal implant
celecoxib/tramadol
drospirenone/ethinyl estradiol
resorcinol/sulfur
eflornithine
rifampin/isoniazid/pyrazinamide
tofersen
devil’s claw
ticarcillin/clavulanate
atropine/pralidoxime
aprepitant
suramin
phenelzine
artichoke
american dogwood
attapulgite
atlantic cedar
axalimogene filolisbac
sodium thiosulfate & sodium nitrite
ataluren
omidubicel-onlv
capsicum
ginger
cryoprecipitate
bictegravir/emtricitabine/tenofovir DF
emtricitabine/tenofovir DF
fo-ti
siberian ginseng
granulocytes
zinc substituted heme C
zinc trihydroxide
ashwagandha 
cat’s claw
glandular products
SAMe
shark cartilage
altovis
feverfew
horse chestnut
magnesium aspartate
octacosanol
pleurisy root
star anise
butterbur
elderberry
licorice (Suppl/herb)
aconite
pentetate zinc trisodium
menthol topical/zinc oxide topical
corn-starch/kaolin/zinc oxide topical
5-htp
butcher’s broom
articulin
bearberry
goldenrod
progesterone, natural
black cohosh
wild yam
cranberry
dong quai
phytoestrogens
norethindrone
false Unicorn Root
raspberry Leaf
asafoetida
turmeric
dehydroepiandrosterone (DHEA)
hyaluronan
aliskiren/amlodipine
octreotide (Antidote)
tranexamic acid injection
duocal
neocate infant formula
pediatric Eo28
aloe
red clover
propolis
androstenedione
heartsease
comfrey
bilberry
chamomile
eyebright
calendula
sage
yucca
polypody
odevixibat
vinpocetine
olanzapine/samidorphan
creatine
yerba mate
spesolimab
azficel-T
tiludronate
estetrol and drospirenone
pseudoephedrine/fexofenadine
lincomycin
neomycin oral
fluocinolone acetonide, otic
tretinoin/ hydroquinone/ fluocinolone
halobetasol topical
hydrocortisone/iodoquinol
penicillin G procaine /penicillin G benzathine
hydrocortisone probutate topical
colistin/neomycin/hydrocortisone/thonzonium otic
ebola zaire vaccine
hepatitis a/b vaccine
vibegron
lindane
nystatin topical
respiratory syncytial virus (RSV) vaccine
chikungunya vaccine
tenecteplase
reteplase
anthrax vaccine adsorbed, adjuvanted
meningococcal ABCWY pentavalent vaccine
eculizumab
cholestyramine
tinzaparin
taurolidine/citrate/heparin
protein C concentrate
antithrombin alfa
antithrombin III
multivitamins, vision
ibuprofen/chlorpheniramine/pseudoephedrine
acetaminophen/ibuprofen
ibuprofen/pseudoephedrine
paclitaxel protein-bound
acetic acid vaginal
acetic acid otic
hydrocodone/ ibuprofen
methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
ibuprofen and phenylephrine
acetylcysteine (Antidote)
iron/folic acid/vitamin/mineral
iobenguane I-131
dolutegravir/rilpivirine
chlorhexidine topical
chlorhexidine oral
thyroid desiccated
proparacaine ophthalmic
podophyllum resin
phendimetrazine
phenoxybenzamine
polidocanol
phentermine and topiramate
piflufolastat F18
piperacillin/tazobactam
prednisolone and gentamicin ophthalmic
promethazine and codeine
poractant alfa
protamine sulfate
aflibercept intravitreal
prednicarbate
promethazine/dextromethorphan
codeine, phenylephrine, and promethazine
potassium phosphate
glatiramer acetate
gentamicin (Ophthalmic)
leniolisib
rezafungin
fluorometholone
dalfampridine
hydrocortisone topical 
empagliflozin and linagliptin
triamcinolone topical
minocycline topical
minocycline dental
ketotifen ophthalmic
darunavir and cobicistat
lidocaine topical
neomycin/polymyxin B/bacitracin/lidocaine (OTC)
lidocaine/ hydrocortisone
lidocaine anesthetic
lidocaine ophthalmic
lidocaine/tetracaine
desonide
dabigatran
fexofenadine
fluoride
decitabine and cedazuridine
dasiglucagon
hydroxypropyl cellulose ophthalmic
epoetin alfa
ibritumomab tiuxetan
trimethobenzamide
dexamethasone/ tobramycin
tafasitamab
valacyclovir
mebendazole
levoleucovorin
flaxseed
germanium
glutathione
lycopene
pygeum
horseradish
ziv-aflibercept
micafungin
trofinetide
taliglucerase alfa
tildrakizumab
sulopenem (Pending FDA Approval)
thyrotropin alfa
birch
thrombin, topical
tivozanib
tafluprost
methohexital
urea and hydrocortisone
unoprostone ophthalmic
trihexyphenidyl
ezetimibe
evolocumab
trifluridine and tipiracil
methenamine
misoprostol
miltefosine
rimantadine
maralixibat
coenzyme Q10
chlorella
garlic
forskolin
zavegepant
menotropins
margetuximab
meprobamate
melarsoprol
evening primrose oil
lemongrass
molindone
fenugreek
phytosterols
red yeast rice
uridine triacetate
tropicamide
incobotulinumtoxinA
Grape Seed Extract
carbachol ophthalmic
cosyntropin
cyclopentolate and phenylephrine
carteolol ophthalmic
pentazocine/naloxone
pentazocine/acetaminophen
casimersen
carisoprodol, aspirin, and codeine
carisoprodol
carboprost tromethamine
flurandrenolide
brinzolamide/brimonidine
betamethasone topical
omaveloxolone
bardoxolone
allogeneic processed thymus tissue
fluocinolone topical
tacrolimus topical
ruxolitinib topical
pimecrolimus topical
sofosbuvir, velpatasvir and voxilaprevir
sofosbuvir/velpatasvir
mitotane
elbasvir/grazoprevir
wheat dextrin
vanadium
iron/folic acid/vitamin/mineral
molybdenum
sparsentan
velmanase alfa-tycv
pegcetacoplan
ferrous sulfate
cyclosporine ophthalmic
ferric pyrophosphate
ammonium lactate
etelcalcetide
iodoquinol
sucroferric oxyhydroxide
doxercalciferol
terconazole vaginal
cortisone
pyronaridine
tetrahydrozoline, ophthalmic
tenapanor
tesamorelin
benazepril/hydrochlorothiazide
nadolol and bendroflumethiazide
spironolactone and hydrochlorothiazide
COVID-19 Vaccine, mRNA
atosiban
bisoprolol and hydrochlorothiazide
ephedrine/guaifenesin
clonidine/chlorthalidone
captopril/hydrochlorothiazide
amlodipine/valsartan/hydrochlorothiazide
hydrochlorothiazide and irbesartan
candesartan/hydrochlorothiazide
ciclesonide intranasal
cromolyn sodium ophthalmic
methyldopa/hydrochlorothiazide
valsartan/hydrochlorothiazide
hydrochlorothiazide and triamterene
moexipril/hydrochlorothiazide
mometasone/intranasal
ofloxacin ophthalmic
cysteamine
metoprolol/hydrochlorothiazide
amlodipine/olmesartan
eprosartan/hydrochlorothiazide
amlodipine/telmisartan
hydrochlorothiazide/aliskiren
betamethasone/clotrimazole
telmisartan/hydrochlorothiazide
benazepril/amlodipine
bezlotoxumab
propranolol/hydrochlorothiazide
bupropion/naltrexone
burosumab
acetylcholine chloride intraocular solution
bupivacaine and meloxicam
budesonide and formoterol (inhalation)
valerian
entacapone/levodopa/carbidopa
carbidopa/levodopa
calaspargase pegol
cabotegravir
cefixime
calfactant
brinzolamide
daprodustat
brimonidine and timolol
brodalumab
buprenorphine and naloxone
hydrocortisone acetic acid otic
butorphanol
butoconazole
adapalene and benzoyl peroxide
acrivastine and pseudoephedrine
neomycin/polymyxin B/bacitracin topical
midodrine
baloxavir marboxil
bacitracin, neomycin, polymyxin B, and hydrocortisone topical
avatrombopag
glucagon
atenolol/chlorthalidone
adefovir
activated charcoal
avalglucosidase alfa
aclidinium and formoterol
iclaprim (Pending FDA Approval)
ampicillin/sulbactam
quinupristin/dalfopristin
lamivudine/zidovudine/abacavir
acetaminophen and caffeine
acetaminophen/pamabrom
abacavir and lamivudine
anifrolumab
elacestrant
anidulafungin
acetohydroxamic acid
alogliptin/pioglitazone
anthralin
pirtobrutinib
gabapentin
galsulfase
gadoterate meglumine
ferric gluconate
ferric derisomaltose
ethanolamine oleate
eteplirsen
vasopressin
desmopressin
meropenem/vaborbactam
ecallantide
econazole topical
dornase alfa
aspirin/dipyridamole
dipyridamole
difenoxin and atropine
diflorasone
difluprednate ophthalmic
eptinezumab
diethylpropion
dexchlorpheniramine
dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate
bexagliflozin
galcanezumab
fremanezumab
tapinarof topical
darifenacin
dalbavancin
darbepoetin alfa
azilsartan
colestipol
corticorelin
crotamiton
crofelemer
allogeneic cultured keratinocytes/fibroblasts in bovine collagen
tapentadol
cyclopentolate
polymyxin B/bacitracin topical
tavaborole
tagraxofusp
crisaborole
crizanlizumab
satralizumab
spinosad
sacubitril/valsartan
sargramostim
sebelipase alfa
regadenoson
ribociclib/letrozole
ragweed allergen extract
radium-223 dichloride
secnidazole
setmelanotide
polycarbophil
plecanatide
sacituzumab govitecan
pertuzumab
pertuzumab/trastuzumab/hyaluronidase
pamidronate
halcinonide
glecaprevir/pibrentasvir
glucarpidase
golodirsen
dextrose (antidote)
hexaminolevulinate
iohexol
ferric citrate
elapegademase
emicizumab
erenumab
danaparoid
dantrolene
eflapegrastim
edaravone
amcinonide
carglumic acid
alcaftadine ophthalmic
agalsidase beta
afamelanotide
fosdenopterin
lidocaine and chlorhexidine
levorphanol
calcifediol
factor VIIa, recombinant
triheptanoin
peanut oral allergen powder
teprotumumab
poly-L-lactic acid/carboxymethylcellulose/mannitol
xenon Xe 129 hyperpolarized
ublituximab
anacaulase
glatiramer
peginterferon beta-1a
interferon beta-1a
onabotulinumtoxinA
cycloserine
ethionamide
cabotegravir and rilpivirine
vericiguat
omidenepag isopropyl
azelastine/fluticasone intranasal
benzyl peroxide
vutrisiran
brimonidine
testosterone topical
lenacapavir
tebentafusp
mosunetuzumab
faricimab
ganirelix
nadofaragene firadenovec
ozenoxacin
guaifenesin
adagrasib
guselkumab
adalimumab-aacf
nonoxynol-9
nifurtimox
nusinersen
nitazoxanide
mavacamten
calcipotriene
bimatoprost
obinutuzumab
amifostine
oxycodone/aspirin
oxycodone/ibuprofen
oteseconazole
oxychlorosene
porfimer
pramoxine /hydrocortisone topical
podofilox
quinapril/hydrochlorothiazide
acetaminophen/pamabrom/pyrilamine
levobunolol
paregoric
idursulfase
lesinurad and allopurinol
latanoprost/netarsudil ophthalmic
lactase enzyme
bioadherent oral
latanoprost and timolol
latanoprostene bunod
ledipasvir/sofosbuvir
imipenem/cilastatin/relebactam
imipenem/cilastatin
hemin
deucravacitinib
house dust mite allergen extract
halobetasol topical/tazarotene
remimazolam
somatropin
remifentanil
ethotoin
etidronate
empagliflozin, linagliptin, and metformin
elvitegravir/cobicistat/emtricitabine/tenofovir AF
empagliflozin/metformin
evinacumab
finasteride and tadalafil
flortaucipir (18F)
proparacaine/ fluorescein ophthalmic
fluorescein/benoxinate ophthalmic
fluphenazine
alogliptin/metformin
alogliptin/pioglitazone
alitretinoin topical
dextrose/ sodium citrate/fructose
dasabuvir
ombitasvir/paritaprevir/ritonavir
hydrocodone/chlorpheniramine/pseudoephedrine
hydroxyamphetamine/tropicamide
acamprosate
gadobutrol
teclistamab
tremelimumab
futibatinib
etranacogene dezaparvovec
olutasidenib
naproxen and diphenhydramine
naratriptan
gadopiclenol
gadoxetate
gadoversetamide
naphazoline/pheniramine
naphazoline
nalbuphine
vosoritide
vitamin K1 (phytonadione)
moxidectin
basiliximab
fecal microbiota, live-jslm
ibuprofen/famotidine
famotidine
raxibacumab
omalizumab
measles, mumps, rubella, and varicella vaccine, live (Rx)
senna/docusate
dinoprostone
measles mumps and rubella vaccine, live
immune globulin IM (IGIM)
dyclonine
doravirine, lamivudine, and tenofovir disoproxil fumarate
elexacaftor/tezacaftor/ivacaftor
ivacaftor/tezacaftor
treosulfan
tranexamic acid
norethindrone acetate/estradiol/elagolix
artesunate
trientine
trifarotene
ziconotide
vonoprazan/amoxicillin/clarithromycin
pyrithione zinc
zinc oxide topical
naphazoline/zinc sulfate/glycerin ophthalmic
voretigene neparvovec
nirmatrelvir/ritonavir
bebetelovimab
sodium chloride
relugolix/estradiol/norethindrone
defibrotide
prothionamide
liraglutide/insulin degludec
etilfrine
alpha-lipoic acid
ramosetron
olodaterol/tritropium
cimetropium
umeclidinium
itopride
secretin
naftopidil
trimeprazine
benperidol
chlormethiazole
multivitamins
secukinumab
glycopyrrolate inhaled and formoterol
amitriptyline and chlordiazepoxide
tirzepatide
relugolix/estradiol/norethindrone
mupirocin
alvimopan
chlordiazepoxide
insulin regular human
insulin aspart protamine/insulin aspart
insulin isophane human/insulin regular human
insulin degludec/insulin aspart
teplizumab
chlordiazepoxide/clidinium
aspirin, sodium bicarbonate, and citric acid
aluminum hydroxide, magnesium hydroxide, and simethicone
glycopyrrolate inhaled
olodaterol/tiotropium
umeclidinium bromide
timolol/dorzolamide
travoprost ophthalmic
loxapine
eptifibatide
hydrocodone/acetaminophen
omega 3 fatty acids
trandolapril/verapamil
abciximab
artificial saliva
diphtheria, hepatitis B, pertussis (acellular), polio, and tetanus vaccine
diphtheria, haemophilus B, pertussis, polio, tetanus vaccine
haemophilus influenzae type b vaccine/hepatitis b vaccine
butalbital/aspirin/caffeine 
colchicine/probenecid
atovaquone and proguanil
ursodiol
chenodiol
casirivimab/imdevimab
tixagevimab/cilgavimab
molnupiravir
bebtelovimab
calcium, magnesium, potassium and sodium oxybate
sodium oxybate
diphtheria, polio, pertussis acellular, tetanus vaccine
pseudoephedrine loratadine
sodium chloride nasal
hydroxychloroquine sulfate
atorvastatin and ezetimibe
teriparatide
alendronate and cholecalciferol
alprostadil (IV)
romosozumab
risedronate
alendronate
glyburide/metformin
clorazepate
rosuvastatin/ezetimibe
paclitaxel/encequidar
valsartan/amlodipine
enalapril/hydrochlorothiazide
enalapril and felodipine
amiloride/hydrochlorothiazide
triamterene/hydrochlorothiazide
lisinopril/hydrochlorothiazide
tegaserod
rhein
ritanserin
sulfaphenazole
sulconazole
taurursodiol
bromeperidol
carbapenems
fotemustine
difelikefalin
bromopride
alizapride
olopatadine
oxomemazine
paraldehyde
oxcarbazepine
kratom
elexacaftor
oritavancin
miocamycin
curcumin sulfate
seproxetine
clotrimazole
remacemide
piperine
ditiocarb
danoprevir
oxetacaine
topiroxostat
indisulam
tofisopam
noscapine
thiopental
tioconazole
nicotinamide
rutin
mequitazine
somatostatin
vapreotide
econazole
saracatinib
lestaurtinib
efonidipine
zimelidine
indalpine
desvenlafaxine
benidipine
dapoxetine
tesmilifene
pergolide
sitaxentan
resveratrol
bifonazole
tildipirosin
solithromycin
selamectin
imiquimod topical
fluorouracil topical
peginterferon alfa-2b
interferon alfa-2b
alteplase
tanshinone I
rosmarinic acid
caryophyllene
ursolic acid
cepharanthine
veliflapon
mirikizumab
cp-96345
famprofazone
peoniflorin
fepradinol
licofelone
polmacoxib
ebselen
taxifolin
betulinic acid
flurbiprofen axetil
talniflumate
morniflumate
nitroaspirin
firocoxib
ns-398
cimicoxib
robenacoxib
sc-236
imidazole salicylate
trolamine salicylate
pirprofen
benorilate
ethenzamide
mofebutazone
proquazone
carbaspirin calcium
guacetisal
proglumetacin
propyphenazone
pranoprofen
bendazac
tenidap
lonazolac
nifenazone
flunoxaprofen
difenpiramide
feprazone
bufexamac
alminoprofen
suxibuzone
fentiazac
tinoridine
tepoxalin
indobufen
flunixin
propacetamol
clonixin
droxicam
epirizole
etofenamate
ibuproxam
indoprofen
kebuzone
felbinac
zaltoprofen
azapropazone
zomepirac
niflumic acid
magnesium salicylate
suprofen
nepafenac
bromfenac
ciprofloxacin and hydrocortisone (otic) (Rx)
hydrocortisone/neomycin/polymyxin otic (Rx)
vigabatrine
valproate sodium injection
tezepelumab (Rx)
triamcinolone acetonide/nystatin
triamcinolone suprachoroidal (Rx)
triamcinolone, intranasal
ciclesonide inhaled
diosmin
tirbanibulin
padeliporfin
roxadustat
aminosalicylic acid
rasburicase
tetracaine
articaine
ropivacaine
nitrous oxide
sulfapyridine
sulfanilamide
mafenide
isometheptene
amyl nitrite
antipyrine
isosorbide dinitrate
prilocaine
nitroglycerin
tobacco
batefenterol
hexoprenaline
pf-00610355
racepinephrine
protokylol
doxofylline
phenylpropanolamine
isoetharine
ephedra sinica root
dipivefrin
arbutamine
norepinephrine
fenoterol
clenbuterol
pirbuterol
epinephrine
ritodrine
procaterol
orciprenaline
bitolterol
abediterol
fluticasone furoate, umeclidinium and vilanterol
fluticasone furoate and vilanterol
mometasone and formoterol
pramoxine topical (OTC)
menthol/pramoxine (topical)
tetrastarch
plasma protein fraction
hetastarch
rokitamycin
ridaforolimus
oleandomycin
patupilone
mitemcinal
midecamycin
mirvetuximab soravtansine
lorvotuzumab mertansine
kitasamycin
flurithromycin
eprinomectin
epofolate
epothilone D
coltuximab ravtansine
dirithromycin
doramectin
cethromycin
carbomycin
paramethasone
dexamethasone isonicotinate
quinupristin
sarilumab
dalfopristin
curcumin
luliconazole
procaine
chloroprocaine
phencyclidine
tenocyclidine
profenamine
halothane
lfenprodil
calcium levulinate
agmatine
calcium pangamate
calcium glubionate
edodekin alfa
beloranib
aflibercept
endostar
volociximab
roquinimex
anecortave acetate
squalamine
brolucizumab
trebananib
semaxanib
endostatin
halofuginone
resveratol
ranibizumab
fumagilin
bevacizumab
hyperforin
aminohippuric acid
opicapone
pafolacianine
bempedoic acid
belantamab mafodotin
prasterone
glecaprevir
levomenol
parachlorophenol
gadoxetic acid
cholecystokinin
caspofungin
ouabain
rifampicin
taurocholic acid
methylphosphinic acid
revefenacin
isoprenaline
posiphen
acotiamide
triflupromazine
pegvisomant
pipecuronium
regramostim
phenserine
diethylcarbamazine
cinchocaine
pancuronium
bambuterol
hexafluronium
aprotinin
tyrothricin
decamethonium
ipidacrine
tubocurarine
paraoxon
ginkgo biloba
methanesulfonyl fluoride
dichlorvos
fenthion
metrifonate
coumaphos
huperzine A
distigmine
neostigmine
isoflurophate
tasosartan
fimasartan
methylthioninium
minaprine
gallamine triethiodide
ambenonium
abiraterone
mibefradil
hydrocortisone (systemic)
cetirizine (systemic)
Talimogene Laherparepvec
Diacerein
magnesium glucoheptonate
acyclovir and hydrocortisone
acyclovir (ophthalmic)
acyclovir (topical)
docosanol cream
camphor and phenol
dolutegravir, abacavir, and lamivudine
peramivir
lisdexamfetamine
ergoloid mesylates
memantine/donepezil
tranylcypromine
isocarboxazid
methenamine/sodium salicylate/benzoic acid
mometasone topical (Rx)
Esketamine intranasal
Oracit
Shohls Solution
sodium lactate
sodium citrate
lecanemab
donepezil (Rx)
donepezil transdermal
sodium thiosulfate
ciclopirox
undecylenic acid
butenafine
calcium and vitamin D
zoledronic acid
calcitonin salmon
pizotifen
indoramin
salicylic acid acne

diroximel fumarate +

measles, mumps, rubella, and varicella vaccine, live (Rx)

may diminish the therapeutic effect of vaccines

measles mumps and rubella vaccine, live

may diminish the therapeutic effect of vaccines

cOVID-19 subunit vaccine

may diminish the therapeutic effect of vaccines

vaccinia immune globulin intravenous (Rx)

may diminish the therapeutic effect of vaccines

smallpox and monkeypox vaccine (live, nonreplicating) (US: Availability limited to health department/CDC expanded access protocol) (Rx)

may diminish the therapeutic effect of vaccines

poliovirus vaccine, live, trivalent

may diminish the therapeutic effect of vaccines

poliovirus vaccine inactivated

may diminish the therapeutic effect of vaccines

measles, mumps, rubella, and varicella vaccine, live (Rx)

may diminish the therapeutic effect of vaccines

measles mumps and rubella vaccine, live

may diminish the therapeutic effect of vaccines

cOVID-19 subunit vaccine

may diminish the therapeutic effect of vaccines

smallpox (vaccinia) vaccine, live

may diminish the therapeutic effect of vaccines

cOVID-19 vaccine

may diminish the therapeutic effect of vaccines

cOVID-19 Vaccine, mRNA

may reduce the therapeutic effect of vaccines

remdesivir

may have a decreased therapeutic effect when combined with covid-19 vaccine

cOVID vaccine

Immunosuppressants may reduce the therapeutic effect of COVID-19 Vaccine

denosumab

it may enhance the immunosuppressive effect of Immunosuppressants

influenza virus vaccine

it may diminish the therapeutic effect of Influenza Virus Vaccines

influenza virus vaccine h n live

it may diminish the therapeutic effect of Influenza Virus Vaccines

influenza virus vaccine (h n ) adjuvanted

it may diminish the therapeutic effect of Influenza Virus Vaccines

influenza a (h n ) vaccine

it may diminish the therapeutic effect of Influenza Virus Vaccines

poliovirus vaccine, live, trivalent

immunosuppressants may diminish the therapeutic effect of Vaccines

poliovirus vaccine inactivated

immunosuppressants may diminish the therapeutic effect of Vaccines

cOVID-19 subunit vaccine

immunosuppressants may diminish the therapeutic effect of vaccines

vaccinia immune globulin intravenous (Rx)

immunosuppressants may diminish the therapeutic effect of vaccines

smallpox and monkeypox vaccine (live, nonreplicating) (US: Availability limited to health department/CDC expanded access protocol) (Rx)

immunosuppressants may diminish the therapeutic effect of vaccines

cOVID-19 vaccine

immunosuppressants may diminish the therapeutic effect of vaccines

pneumococcal vaccine

immunosuppressants may diminish the therapeutic effect of vaccines

cOVID-19 Vaccine, mRNA

may decrease the therapeutic effect of COVID-19 vaccine

pimecrolimus topical

may increase the immunosuppressive effect of tacrolimus

sipuleucel-T

may decrease the therapeutic effect when combined with sipuleucel-t

cOVID-19 Vaccine, mRNA

may decrease the therapeutic effect when combined with vaccines

coccidioidin skin test

may decrease the diagnostic effect when combined with coccidioides immitis test

belimumab

belimumab's immunosuppressive properties reduce the efficacy of the live rotavirus oral vaccine, leading to diminished effects

ustekinumab

may increase the immunosuppressive effect of immunosuppressants

siltuximab

may increase the immunosuppressive effect of immunosuppressants

risankizumab

may increase the immunosuppressive effect of immunosuppressants

reslizumab

may increase the immunosuppressive effect of immunosuppressants

canakinumab

may increase the immunosuppressive effect of immunosuppressants

rilonacept

may increase the immunosuppressive effect of immunosuppressants

anakinra

may increase the immunosuppressive effect of immunosuppressants

etanercept

may increase the immunosuppressive effect of immunosuppressants

5-htp

may increase the immunosuppressive effect of Immunosuppressants

respiratory syncytial virus vaccine, adjuvanted

may increase the immunosuppressive effect of Immunosuppressants

respiratory syncytial virus (RSV) vaccine

may increase the immunosuppressive effect of Immunosuppressants

cOVID-19 subunit vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

vaccinia immune globulin intravenous (Rx)

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

smallpox and monkeypox vaccine (live, nonreplicating) (US: Availability limited to health department/CDC expanded access protocol) (Rx)

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

cOVID-19 vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

pneumococcal vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

poliovirus vaccine, live, trivalent

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

poliovirus vaccine inactivated

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

cOVID-19 subunit vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

smallpox (vaccinia) vaccine, live

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

cOVID-19 vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

poliovirus vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

adenovirus vaccine type 7

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

idecabtagene vicleucel

It may enhance the immunosuppressive effects when combined with idecabtagene vicleucel

dengue vaccine

immunosuppressants may enhance the adverse/toxic effect of dengue Vaccine

cOVID-19 subunit vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

smallpox (vaccinia) vaccine, live

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

cOVID-19 vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

poliovirus vaccine

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

adenovirus vaccine type 7

Immunosuppressants may enhance the adverse/toxic effect of Vaccines

bcg vaccine

may enhance the adverse/toxic effect of BCG products

abrocitinib

may increase the immunosuppressive effect of immunosuppressants

cOVID-19 subunit vaccine

may increase the adverse/toxic effect of immunosuppressants

vaccinia immune globulin intravenous (Rx)

may increase the adverse/toxic effect of immunosuppressants

smallpox and monkeypox vaccine (live, nonreplicating) (US: Availability limited to health department/CDC expanded access protocol) (Rx)

may increase the adverse/toxic effect of immunosuppressants

cOVID-19 vaccine

may increase the adverse/toxic effect of immunosuppressants

pneumococcal vaccine

may increase the adverse/toxic effect of immunosuppressants

poliovirus vaccine, live, trivalent

may increase the adverse/toxic effect of immunosuppressants

poliovirus vaccine inactivated

may increase the adverse/toxic effect of immunosuppressants

cOVID-19 subunit vaccine

may increase the adverse/toxic effect of immunosuppressants

smallpox (vaccinia) vaccine, live

may increase the adverse/toxic effect of immunosuppressants

cOVID-19 vaccine

may increase the adverse/toxic effect of immunosuppressants

poliovirus vaccine

may increase the adverse/toxic effect of immunosuppressants

adenovirus vaccine type 7

may increase the adverse/toxic effect of immunosuppressants

measles, mumps, rubella and varicella vaccine, live

may increase the toxic effects of varicella virus containing vaccine

rubella vaccine

it increases the toxicity of rubella or varicella-containing live vaccines

measles, mumps, rubella, and varicella vaccine, live (Rx)

may enhance the adverse/toxic effect of rubella, and varicella vaccine, live 

baricitinib

immunosuppressants increase the effect of baricitinib

bcg vaccine

immunosuppressants increase the toxicity of BCG products

cladribine

immunosuppressants increase the effect of immunosuppression of cladribine

dengue vaccine

immunosuppressants increase the toxicity of the dengue tetravalent vaccine

natalizumab

immunosuppressants increase the effect of immunosuppression of natalizumab

pimecrolimus

it increases the effect of immunosuppressants

poliovirus vaccine

immunosuppressants increase the toxicity of the poliovirus vaccine

ruxolitinib

immunosuppressants increase the effect of immunosuppression of ruxolitinib

tacrolimus

immunosuppressants increase the effect of immunosuppression of tacrolimus

talimogene Laherparepvec

immunosuppressants increase the toxicity of talimogene laherparepvec

tofacitinib

immunosuppressants increase the effect of immunosuppression of tofacitinib

typhoid vaccine

immunosuppressants increase the toxicity of the typhoid vaccine

upadacitinib

immunosuppressants increase the effect of immunosuppression of upadacitinib

measles, mumps, rubella, and varicella vaccine, live (Rx)

immunosuppressants increase the toxicity of live vaccines

measles mumps and rubella vaccine, live

immunosuppressants increase the toxicity of live vaccines

yellow fever vaccine

immunosuppressants increase the toxicity of the yellow fever vaccine

dimethyl fumarate

may increase the toxic effect

ruxolitnib topical

may increase the immunosuppressive effect of immunosuppressive agents

deucravacitinib

may have an increased immunosuppressive effect when combined with immunosuppressants

tacrolimus topical

may increase the immunosuppressive effect of tacrolimus

nadofaragene firadenovec

may have an increased adverse effect when combined with nadofaragene firadenovec

bromeperidol

may have an increasingly adverse effect when combined with immunosuppressants

methotrexate

methotrexate can also enhance the immunosuppressive effect of tacrolimus (Topical)

ritlecitinib

may have an increased immunosuppressive effect when combined with ritlecitinib

cladabrine

cladribine: they may increase the immunosuppressive effect of immunosuppressants

beclomethasone (nasal)

may decrease the therapeutic effect of immunosuppressants

fluticasone (topical)

may decrease the therapeutic effect of immunosuppressants

levalbuterol

may decrease the therapeutic effect of immunosuppressants

chlorambucil

may decrease the therapeutic effect of immunosuppressants

albuterol

may decrease the therapeutic effect of immunosuppressants

respiratory syncytial virus vaccine, adjuvanted

may reduce the therapeutic effect of vaccines

respiratory syncytial virus (RSV) vaccine

may reduce the therapeutic effect of vaccines

daratumumab

when both drugs are combined, there may be an increased risk of serious infections  

denileukin diftitox

when both drugs are combined, there may be an increased risk of serious infections  

abrocitinib

it may enhance the immunosuppressive effect of immunosuppressants

cOVID subunit vaccine

immunosuppressants may reduce the therapeutic effect of COVID-19 Vaccine

inebilizumab

Immunosuppressants may enhance the immunosuppressive effect of Inebilizumab.

baricitinib

may enhance the immunosuppressive effect of baricitinib

brincidofovir

immunosuppressants decrease the efficacy of brincidofovir

thioguanine

may increase the therapeutic effect of immunosuppressants

inebilizumab

may have an increased immunosuppressive effect when combined with inebilizumab

ocrelizumab

may have an increased immunosuppressive effect when combined with ocrelizumab

ofatumumab

may have an increased immunosuppressive effect when combined with ofatumumab

pidotimod

may decrease the therapeutic effect when combined with pidotimod

ozanimod

may have an increased immunosuppressive effect when combined with immunosuppressants

fingolimod

may have an increased immunosuppressive effect when combined with immunosuppressants

ponesimod

may have an increased immunosuppressive effect when combined with immunosuppressants

ublituximab

may have an increased immunosuppressive effect when combined with ublituximab

pneumococcal vaccine

may decrease the therapeutic effect when combined with pneumococcal vaccines

antithymocyte globulin rabbit

may have an increasingly adverse effect when combined with antithymocyte globulin

leniolisib

leniolisib reduces the efficacy of the live rotavirus oral vaccine by exerting immunosuppressive effects

obinutuzumab

The immunosuppressive effects of obinutuzumab diminish the effectiveness of the live rotavirus oral vaccine

antithymocyte globulin equine

may have an increasingly adverse effect when combined with antithymocyte globulin

respiratory syncytial virus vaccine, adjuvanted

immunosuppressants decrease the efficacy of vaccines

respiratory syncytial virus (RSV) vaccine

immunosuppressants decrease the efficacy of vaccines

cOVID-19 vaccine

immunosuppressants decrease the efficacy of the COVID-19 vaccine

denosumab

it increases the effect of immunosuppressive agents

influenza virus vaccine

immunosuppressants decrease the efficacy of the influenza virus vaccine

leflunomide

immunosuppressants increase the effect of immunosuppression of leflunomide

rabies vaccine

immunosuppressants decrease the efficacy of the rabies vaccine

measles, mumps, rubella, and varicella vaccine, live (Rx)

immunosuppressants decrease the efficacy of vaccines

measles mumps and rubella vaccine, live

immunosuppressants decrease the efficacy of vaccines

Dosage Forms & Strengths

delayed release, capsule

231mg

Multiple Sclerosis

Initial dose: 231 mg orally twice a day
Maintenance: may increase to 462 mg (231- of each capsule) After one week, orally twice a day
Not able to tolerate the maintenance dose
If the maintenance dosage is not tolerated, consider reducing the dose temporarily to 231 mg orally twice a day.
Resuming dosage in 4 weeks at 462 mg orally twice a day
If a patient cannot tolerate an increased dose to the maintenance level, consider discontinuing the medication.

Dose Adjustments

Dosage Modifications
Hepatic impairment
Hepatic impairment has not been the subject of any studies.
No dose adjustments are required since it is not expected to affect the exposure of monomethyl fumarate (MMF).
Renal impairment
Mild: dose adjustment is not required
Moderate to severe: usually not recommended

Safety & efficacy were not established

Refer to the adult dosing regimen

Frequency defined

1-10%

Pruritus (8%)

presence of Albumin urine (6%)

Dyspepsia (5%)

Lymphopenia (2%)

Vomiting (9%)

Rash (8%)

Erythema (5%)

increased AST (4%)

Frequency not defined

Transient increase in the mean eosinophil count

Post marketing Reports

Rhinorrhea

Acute pancreatitis

Liver function abnormalities

Herpes zoster infection

Alopecia

opportunistic infections

Black Box Warning:

there is no black box warning associated with diroximel fumarate.

Contraindication/Caution:

Contraindication:

diroximel fumarate is contraindicated in individuals with a known hypersensitivity to diroximel fumarate or any of its components. It is contraindicated in severe renal impairment. Additionally, diroximel fumarate should not be used concomitantly with dimethyl fumarate, as they are similar drugs.

Caution:

Lymphopenia: diroximel fumarate may cause a decrease in lymphocyte counts, particularly in the initial treatment period. Regular monitoring of lymphocyte counts is recommended.
Progressive Multifocal Leukoencephalopathy (PML): PML, a rare and serious brain infection, has been reported with other drugs that affect the immune system.
Hepatotoxicity: diroximel fumarate has been associated with liver injury. Liver function tests should be monitored before starting treatment and periodically thereafter.
Allergic reactions: Hypersensitivity reactions, including serious skin reactions, have been reported with diroximel fumarate.
Pregnancy and breastfeeding: The use of diroximel fumarate during pregnancy or breastfeeding should be carefully considered, as there is limited data available.

Comorbidities:

Liver disease: diroximel fumarate may affect liver function, and individuals with pre-existing liver disease may be at a higher risk of liver toxicity. Regular liver function tests are recommended.
Kidney disease: Although diroximel fumarate is primarily metabolized in the liver, caution is still advised in individuals with severe kidney impairment. Close monitoring of kidney function may be necessary.
Infections: diroximel fumarate may affect the immune system, and individuals with a history of recurrent or chronic infections may require close monitoring for potential exacerbation or development of new infections.
Cardiovascular disease: As with any medication, individuals with a history of cardiovascular disease should be monitored closely while taking diroximel fumarate. This is particularly important for individuals at a higher risk of cardiovascular events, such as those with heart attack or stroke.
Autoimmune disorders: diroximel fumarate may modulate the immune system, and caution is advised in individuals with other autoimmune disorders. Close monitoring for potential exacerbation of underlying autoimmune conditions may be necessary.

Pregnancy consideration: N/A

Lactation: Not excreted into the human milk as a parent drug, but excretes as an active metabolite i.e., monomethyl fumarate.

Pregnancy category:

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.
<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women. 
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category.

Pharmacology:

diroximel fumarate is prodrug of monomethyl fumarate (MMF). Once ingested, diroximel fumarate is rapidly converted to MMF in the gastrointestinal tract. The exact mechanism of action of diroximel fumarate and MMF in multiple sclerosis is not fully understood. However, it is believed that MMF exerts its therapeutic effects through its immunomodulatory properties.

It can activate the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathways, leading to the upregulation of antioxidant and cytoprotective genes. This helps to reduce oxidative stress and inflammation, that play a role in pathogenesis of multiple sclerosis.

Pharmacodynamics:

The pharmacodynamics of diroximel fumarate are attributed to its active metabolite, monomethyl fumarate (MMF). MMF is known to exhibit immunomodulatory and antioxidant effects, which play a role in its therapeutic actions.

Immunomodulatory effects: MMF can modulate the immune system by suppressing pro-inflammatory responses. It inhibits the activation, proliferation, and migration of various immune cells, including T cells and dendritic cells. This modulation of immune cell activity helps to reduce the immune-mediated inflammation seen in conditions like multiple sclerosis.
Antioxidant effects: MMF activates the nuclear factor (erythroid-derived 2)-like 2 (Nrf2) pathways, which upregulates the expression of antioxidant and cytoprotective genes. This results in increased production of cellular antioxidants and enhanced defense against oxidative stress.

Pharmacokinetics:

Absorption

diroximel fumarate is rapidly and efficiently absorbed after oral administration. It is a prodrug that rapidly converts to its active metabolite, monomethyl fumarate (MMF), in the gastrointestinal tract. MMF is then absorbed into the systemic circulation.

Distribution

MMF is extensively distributed throughout the body. It has higher affinity for plasma proteins, primarily albumin. MMF can cross the blood-brain barrier and distribute into the central nervous system.

Metabolism

Once in the body, MMF undergoes further metabolism via several pathways, including hydrolysis and oxidation. The major metabolite of MMF is fumaric acid, a naturally occurring substance in the body. MMF is also involved in the tricarboxylic acid cycle and is metabolized to carbon dioxide.

Elimination and excretion

The elimination of diroximel fumarate and its metabolites primarily occurs via renal excretion. After metabolism, the resulting fumaric acid and other metabolites are excreted in the urine. A minor portion of diroximel fumarate is excreted in the feces.

Administration:

diroximel fumarate is typically administered orally in the form of capsules. The recommended dosage and administration instructions may vary based on the conditions treated and the prescribed dosing instructions.

diroximel fumarate can be taken with or without food. It is important to follow dosing instructions. Swallow the capsule whole with water, without chewing or crushing it.

If there is a difficulty swallowing capsules, you may consult your healthcare provider or pharmacist for alternative methods of administration, such as opening the capsule and sprinkling the contents onto soft food or mixing it with applesauce.

Patient information leaflet

Generic Name: diroximel fumarate

Pronounced: (dye-rox-i-mel few-ma-rate)

Why do we use diroximel fumarate?

diroximel fumarate is used to treat multiple sclerosis. It is a disease-modifying therapy that helps to decrease the frequency of relapses and slow down the progression of disability associated with Multiple sclerosis. diroximel fumarate is indicated for adults and can be an option for patients who prefer an alternative to other oral medications for Multiple sclerosis.

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