Dimethyl fumarate is thought to reduce the frequency of relapses and delay the progression of MS by activating cellular defences to toxic stimuli through up-regulation of antioxidant response genes. Significantly reduced immune cell activation delivers anti-inflammatory and immunomodulatory effects, and improves the blood brain barrier integrity, to reduce brain lesions and relapses of MS.
Flushing and gastrointestinal events are the most common cause of discontinuation, however immunomodulation decreases lymphocyte counts and may increase the risk of serious infection. Live attenuated vaccines should be avoided.
Simultaneous administration of other fumaric acid derivatives (topical or systemic) or potentially nephrotoxic medicines should be avoided.
Clinical pharmacology studies suggest that no dose adjustments are needed with renal or hepatic impairment.
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