Diroximel fumarate, sold under the brand name Vumerity, is a medication used for the treatment of relapsing forms of multiple sclerosis (MS). It acts as an immunosuppressant and anti-inflammatory drug. Its most common adverse effects are flushing and gastrointestinal problems.Diroximel fumarate was approved for medical use in the United States in October 2019, and in the European Union in November 2021. Medical uses
Diroximel fumarate is used for the treatment of relapsing-remitting multiple sclerosis. In the US, it is additionally approved for other relapsing forms of MS such as clinically isolated syndrome and active secondary progressive disease. Available forms
The drug is available as a white delayed-release capsule that is resistant to gastric acid and only dissolves in the intestine. Contraindications
Under the European Unions label, the drug is contraindicated in people with progressive multifocal leukoencephalopathy (PML), a disease of the brain caused by a virus. In the US, combination with the closely related drug dimethyl fumarate is contraindicated. Side effects
No systematic studies of adverse effects under diroximel fumarate are available. The most common side effects in studies with dimethyl fumarate were flushing (in 34% of patients treated with the drug, versus 5% in the placebo group) and gastrointestinal effects such as diarrhoea (14% versus 10%), nausea (12% versus 9%), abdominal pain (9% versus 4%), vomiting (8% versus 5%), and indigestion (5% versus 3%). Three percent of patients stopped the treatment because of flushing, 4% because of gastrointestinal side effects.
Cetirizine, sold under the brand name Zyrtec among others, is a second-generation antihistamine used to treat allergic rhinitis (hay fever), dermatitis, and urticaria (hives). It is taken by mouth. Effects generally begin within thirty minutes and last for about a day. The degree of benefit is similar to other antihistamines such as diphenhydramine.Common side effects include sleepiness, dry mouth, headache, and abdominal pain. The degree of sleepiness that occurs is generally less than with first generation antihistamines. Use in pregnancy appears safe, but use during breastfeeding is not recommended. The medication works by blocking histamine H1 receptors, mostly outside the brain.It was patented in 1981 and came into medical use in 1987. It is on the World Health Organizations List of Essential Medicines. It is available as a generic medication. In 2020, it was the 52nd most commonly prescribed medication in the United States, with more than 13 million prescriptions. Medical uses
Allergies
Cetirizines primary indication is for hay fever and other allergies. Because the symptoms of itching and redness in these conditions are caused by histamine acting on the H1 receptor, blocking those receptors temporarily relieves those symptoms.Cetirizine is also commonly prescribed to treat acute and (in particular cases) chronic urticaria, more efficiently than any other second-generation antihistamine. Available forms
Cetirizine is available over-the-counter in the US in the form of 5 and 10 mg tablets. A 20 mg strength is available by prescription only. It is also available as a 1 mg/mL syrup for oral administration by prescription.