Dimethyl fumarate 30mg gastro-resistant tablets
Requires a prescription from a doctor or prescriber
Dimethyl fumarate is an agent indicated for the treatment of relapsing forms of multiple sclerosis.[A253942,L43752] The mechanism of action of dimethyl fumarate in multiple sclerosis is not well understood.
Official documents, adverse reaction reporting, and safety monitoring
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Safety monitoring data
Yellow Card reports
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Suspected adverse reactions reported for Dimethyl fumarate
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
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Suspected adverse reactions reported for Dimethyl fumarate
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1 branded products available
MHRA licensed products
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Skilarence 30mg gastro-resistant tablets
This is the NHS Drug Tariff indicative price used for reimbursement purposes. It may not reflect the price paid by patients or pharmacies.
View full Drug TariffSource: NHS Drug Tariff via NHSBSA. Derived from dm+d VMPP (Virtual Medicinal Product Pack) pricing data. Contains public sector information licensed under the Open Government Licence v3.0.
WHO defined daily dose (DDD)
480 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via NHS dm+d BNF mapping files. Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity based on WHO Anatomical Therapeutic Chemical (ATC) classification and NHS BNF section grouping. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Clinical guidelines and formulary information
British National Formulary
Dimethyl fumarate
Source: British National Formulary, NICE. Joint Formulary Committee. Contains public sector information licensed under the Open Government Licence v3.0.
NICE clinical guidance(15)
Dimethyl fumarate for treating relapsing‑remitting multiple sclerosis (TA320)
Dimethyl fumarate for treating moderate to severe plaque psoriasis (TA475)
Diroximel fumarate for treating relapsing–remitting multiple sclerosis (TA794)
Brodalumab for treating moderate to severe plaque psoriasis (TA511)
Deucravacitinib for treating moderate to severe plaque psoriasis (TA907)
Ozanimod for treating relapsing–remitting multiple sclerosis (TA706)
Ocrelizumab for treating relapsing–remitting multiple sclerosis (TA533)
Cladribine for treating active relapsing forms of multiple sclerosis (TA1053)
Tildrakizumab for treating moderate to severe plaque psoriasis (TA575)
Certolizumab pegol for treating moderate to severe plaque psoriasis (TA574)
Beta interferons and glatiramer acetate for treating multiple sclerosis (TA527)
Ponesimod for treating relapsing–remitting multiple sclerosis (TA767)
Peginterferon beta-1a for treating relapsing–remitting multiple sclerosis (TA624)
Ofatumumab for treating relapsing multiple sclerosis (TA699)
Psoriasis: assessment and management (CG153)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
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Supply & product information
Official product databases and supply status monitoring
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Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF codes from NHS Business Services Authority (NHSBSA). ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
1 hour
Mechanism
The mechanism of action of dimethyl fumarate in multiple sclerosis is not well understood.
Food interactions
1 warning
Human targets
2 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
2.5 hours
Half-life
1 hour
Protein binding
27 to 45%
[L43757]…
Volume of distribution
[L43757]
Metabolism
Elimination
60%
Clearance
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
[L43752][L45668][L49831]
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 359 interactions
[L43752]
In vivo carcinogenicity studies found that at doses ranging between 200 and 400 mg/kg/day, mice had a higher incidence of non-glandular stomach and kidney tumors.
The highest dose not associated with tumors in mice (75 mg/kg/day) is equivalent to the recommended human dose (RHD) of 480 mg/day.
[L43752]
Dimethyl fumarate did not show evidence of mutagenicity in the in vitro bacterial reverse mutation (Ames) assay. Dimethyl fumarate was clastogenic in the in vitro chromosomal aberration assay in human peripheral blood lymphocytes in the absence of metabolic activation, but not clastogenic in the in vivo micronucleus assay in the rat.
[L43752]
It has been suggested that dimethyl fumarate exerts its immunomodulatory effects through changes in the composition and phenotype of immune cells. It reduces CNS infiltration and alters the composition of all lymphocyte subpopulations, especially for cytotoxic and effector T cells. This causes a shift from a mainly pro-inflammatory phenotype to an anti-inflammatory one.[A253942]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[L43752]
The time to maximum concentration (tmax) of MMF ranges between 2 and 2.5 hours. In patients with multiple sclerosis given 240 mg of dimethyl fumarate two times a day with food, the Cmax and AUC were 1.87 mg/L and 8.21 mg⋅hr/L, respectively.
High-fat, high-calorie meals decrease the Cmax of MMF by 40% and cause a tmax delay from 2 hours to 5.5 hours; however, these changes are not considered clinically significant.
[L43752]
[L43752]
[L43757]
[L43757]
Cytochrome P450 (CYP) enzymes do not participate in the metabolism of dimethyl fumarate.
[L43757]
[L43757]
[L43757]
Proteins and enzymes this drug interacts with in the body
PMID:14585973 PMID:15379550 PMID:15572695 PMID:15601839 PMID:15983046 PMID:37339955
KEAP1 acts as a key sensor of oxidative and electrophilic stress: in normal conditions, the BCR(KEAP1) complex mediates ubiquitination and degradation of NFE2L2/NRF2, a transcription factor regulating expression of many cytoprotective genes .
PMID:15601839 PMID:16006525
In response to oxidative stress, different electrophile metabolites trigger non-enzymatic covalent modifications of highly reactive cysteine residues in KEAP1, leading to inactivate the ubiquitin ligase activity of the BCR(KEAP1) complex, promoting NFE2L2/NRF2 nuclear accumulation and expression of phase II detoxifying enzymes .
PMID:16006525 PMID:17127771 PMID:18251510 PMID:19489739 PMID:29590092
In response to selective autophagy, KEAP1 is sequestered in inclusion bodies following its interaction with SQSTM1/p62, leading to inactivation of the BCR(KEAP1) complex and activation of NFE2L2/NRF2 .
PMID:20452972
The BCR(KEAP1) complex also mediates ubiquitination of SQSTM1/p62, increasing SQSTM1/p62 sequestering activity and degradation .
PMID:28380357
The BCR(KEAP1) complex also targets BPTF and PGAM5 for ubiquitination and degradation by the proteasome PMID:15379550 PMID:17046835
The dimers bind at kappa-B sites in the DNA of their target genes and the individual dimers have distinct preferences for different kappa-B sites that they can bind with distinguishable affinity and specificity. Different dimer combinations act as transcriptional activators or repressors, respectively. The NF-kappa-B heterodimeric RELA-NFKB1 and RELA-REL complexes, for instance, function as transcriptional activators.
NF-kappa-B is controlled by various mechanisms of post-translational modification and subcellular compartmentalization as well as by interactions with other cofactors or corepressors. NF-kappa-B complexes are held in the cytoplasm in an inactive state complexed with members of the NF-kappa-B inhibitor (I-kappa-B) family. In a conventional activation pathway, I-kappa-B is phosphorylated by I-kappa-B kinases (IKKs) in response to different activators, subsequently degraded thus liberating the active NF-kappa-B complex which translocates to the nucleus.
The inhibitory effect of I-kappa-B on NF-kappa-B through retention in the cytoplasm is exerted primarily through the interaction with RELA. RELA shows a weak DNA-binding site which could contribute directly to DNA binding in the NF-kappa-B complex. Besides its activity as a direct transcriptional activator, it is also able to modulate promoters accessibility to transcription factors and thereby indirectly regulate gene expression.
Associates with chromatin at the NF-kappa-B promoter region via association with DDX1. Essential for cytokine gene expression in T-cells .
PMID:15790681
The NF-kappa-B homodimeric RELA-RELA complex appears to be involved in invasin-mediated activation of IL-8 expression. Key transcription factor regulating the IFN response during SARS-CoV-2 infection PMID:33440148
ATC L04AX07
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Dimethyl fumarate
Additional database identifiers
Drugs Product Database (DPD)
22048
ChemSpider
553171
BindingDB
50504654
PDB
EOU
ZINC
ZINC000003843378
HUGO Gene Nomenclature Committee (HGNC)
HGNC:23177
GeneCards
KEAP1
Guide to Pharmacology
2757
UniProt Accession
KEAP1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:9955
GeneCards
RELA
Guide to Pharmacology
3280
UniProt Accession
TF65_HUMAN
Patent information
9 active patents, 6 expired
Source: DrugBank · CC BY-NC 4.0. Patent data sourced from national patent offices. Expiry dates may not reflect extensions, regulatory exclusivity periods, or legal challenges.
DrugBank citations
If you use DrugBank data in your research, please cite the following publications: