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Diroximel fumarate is a drug used for the treatment of relapsing forms of multiple sclerosis. It acts through its active metabolite, monomethyl fumarate. Oral administration twice a day.
Like its bioequivalent drug, dimethyl fumarate, diroximel fumarate is rapidly absorbed from the gastrointestinal tract and is immediately converted to monomethyl fumarate, the active metabolite of both dimethyl fumarate and diroximel fumarate prodrugs.
At the date of the last update, we found no published data on its excretion in breast milk.
Its low molecular weight and low protein binding facilitate passage into breast milk, but its high volume of distribution and short half-life make it difficult. In fact, the same active metabolite, monomethyl fumarate, when derived from dimethyl fumarate, is known to have negligible excretion in breast milk.
Possible side effects are rare and generally not serious (gastrointestinal and leukopenia), with no immunosuppressive effects or increased frequency of infection.(
Exposure can be minimized by 90% by waiting 3 hours to resume breastfeeding after taking the drug.