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When using dimethyl fumarate, it is essential to be aware of potential interactions and precautions to ensure safe and effective use. Here are some important points to consider:

• Drug Interactions: Exercise caution when taking dimethyl fumarate alongside other medications that may suppress your immune system or increase the likelihood of infection, such as natalizumab and rituximab. These combinations can potentially enhance the risk of adverse effects.

• Similar Medications: Dimethyl fumarate has similarities to diroximel fumarate and monomethyl fumarate. To avoid potential complications or overdose, do not use medications containing diroximel fumarate or monomethyl fumarate concurrently with dimethyl fumarate.

By adhering to these guidelines, you can help mitigate risks and ensure the safe use of dimethyl fumarate. Always consult with your healthcare provider for personalized advice and before making any changes to your medication regimen.

Common side effects:

• Flushing or warmth
• Redness
• Itching
• Burning sensation on the skin
• Stomach or abdominal pain
• Diarrhea
• Nausea
• Vomiting

Less common but important to monitor:

• Signs of infection (persistent sore throat, fever, chills, cough, or blisters)
• Signs of liver damage (persistent nausea or vomiting, loss of appetite, stomach pain, yellowing of the skin or eyes, or dark urine)
• Black or bloody stools
• Vomit resembling coffee grounds
• Coughing up blood

Serious side effects:

• Progressive multifocal leukoencephalopathy (PML)
• Serious allergic reactions (rash, severe itching or swelling, especially of the face, tongue, or throat, severe dizziness, breathing difficulties)

Interactions with high risk of serious adverse effects and should be avoided:

• diroximel fumarate
• monomethyl fumarate

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• natalizumab
• rituximab