Can stopping Vumerity (diroximel fumarate) cause dry mouth?

Dry Mouth After Stopping Vumerity (Diroximel Fumarate)

There is no evidence that stopping Vumerity (diroximel fumarate) causes dry mouth as a discontinuation effect. Dry mouth is not listed as a withdrawal symptom or discontinuation effect of this medication in any of the available guidelines or research.

Understanding Vumerity and Dry Mouth

• Vumerity (diroximel fumarate) is an FDA-approved medication for treating relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults 1
• Vumerity is a prodrug that requires enzymatic conversion to monomethyl fumarate (MMF), which is the active therapeutic component 1
• The available evidence does not indicate dry mouth as either a common side effect of Vumerity or as a discontinuation symptom 1

Medications Known to Cause Dry Mouth

Dry mouth (xerostomia) is a common side effect of many medications, but Vumerity is not prominently mentioned among them:

• Common medication classes associated with dry mouth include:

  • Anticholinergic drugs (e.g., scopolamine, atropine) 2
  • Tricyclic antidepressants 2
  • Bupropion 2
  • Beta-blockers 2
  • Opioids 2
  • Anti-obesity medications 2
  • Muscle relaxants like cyclobenzaprine 3

• Approximately 60% of older adults complain of dry mouth, which is often associated with polypharmacy 4

Discontinuation Effects of Medications

When considering medication discontinuation effects:

• Some medications, particularly antidepressants like SSRIs and SNRIs, can cause discontinuation syndromes when abruptly stopped 5
• Discontinuation symptoms are most marked with short-acting agents like desvenlafaxine, venlafaxine, and paroxetine 5
• Common discontinuation symptoms from medications may include dizziness, headache, nausea, and sensory disturbances, but dry mouth is not typically reported as a discontinuation symptom 5

Management of Dry Mouth (If Present for Other Reasons)

If a patient experiences dry mouth for any reason, management strategies include:

• Optimize hydration by increasing water intake throughout the day and limiting caffeine consumption 2
• Use saliva substitutes such as moisture-preserving mouth rinses, sprays, or gels with neutral pH 2
• Employ salivary stimulants including sugar-free chewing gum, lozenges, or candy containing xylitol 2
• For severe cases, systemic sialagogues such as pilocarpine may be considered 2

Important Considerations

• Xerostomia can significantly impact quality of life and oral health, potentially leading to dental caries, oral infections, and difficulties with eating and speaking 6
• If dry mouth persists after stopping Vumerity, it's important to consider other potential causes, including other medications the patient may be taking 7
• Many medications can cause dry mouth as a side effect during active treatment, but this typically resolves upon discontinuation rather than appearing as a new symptom 8

If a patient develops dry mouth after stopping Vumerity, it would be prudent to investigate other potential causes, as this symptom is not documented as a known discontinuation effect of this medication.