Monomethyl fumarate

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Monomethyl fumarate
Monomethyl fumarate skeletal.svg
Clinical data
Trade namesBafiertam
License data
Routes of
By mouth
ATC code
  • None
Legal status
Legal status
  • (2E)-4-methoxy-4-oxobut-2-enoic acid
CAS Number
PubChem CID
ECHA InfoCard100.018.557 Edit this at Wikidata
Chemical and physical data
Molar mass130.099 g·mol−1
3D model (JSmol)
  • COC(=O)C=CC(=O)O
  • InChI=1S/C5H6O4/c1-9-5(8)3-2-4(6)7/h2-3H,1H3,(H,6,7)/b3-2+

Monomethyl fumarate, sold under the brand name Bafiertam is a medication for the treatment of relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.[1] It is taken by mouth.[1]

The most common adverse reactions are flushing, abdominal pain, diarrhea, and nausea.[1]

It was approved for medical use in the United States in April 2020.[2][3]


Monomethyl fumarate alters the NFE2L2 (Nuclear factor erythroid 2-related factor 2) transcription factor.

NFE2L2 (or NRF2) is a basic leucine zipper (bZIP) protein that regulates the expression of antioxidant proteins that protect against oxidative damage triggered by injury and inflammation. Several drugs that stimulate the NFE2L2 pathway are being studied for treatment of diseases that are caused by oxidative stress.

Two precursors are also approved:

Society and culture[edit]


Monomethyl fumarate is the international nonproprietary name (INN).[11]


  1. ^ a b c d "Bafiertam- monomethyl fumarate capsule". DailyMed. Retrieved 13 February 2022.
  2. ^ "Bafiertam: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 29 April 2020.
  3. ^ "Drug Approval Package: Bafiertam". U.S. Food and Drug Administration (FDA). 30 November 2020. Retrieved 13 February 2022.
  4. ^ "Biogen Idec's Tecfidera (Dimethyl Fumarate) Approved in US as a First-Line Oral Treatment for Multiple Sclerosis" (Press release). Biogen Idec. 27 March 2013. Archived from the original on 12 May 2013. Retrieved 4 June 2013.
  5. ^ "Drug Approval Package: Tecfidera (dimethyl fumarate) Delayed-Release Capsules NDA #204063". U.S. Food and Drug Administration (FDA). 24 December 1999. Retrieved 30 June 2020.
  6. ^ Matthew Dodson et al., Modulating NRF2 in Disease: Timing Is Everything, Annual Review of Pharmacology and Toxicology, Vol. 59, January 2019, Review in Advance first posted online on September 26, 2018,
  7. ^ "Vumerity (Previously BIIB098 and ALKS 8700)". Multiple Sclerosis News Today. 1 November 2019. Retrieved 21 February 2020.{{cite web}}: CS1 maint: url-status (link)
  8. ^ "Biogen and Alkermes Announce FDA Approval of Vumerity (diroximel fumarate) for Multiple Sclerosis". Biogen. Retrieved 21 February 2020.
  9. ^ "Vumerity- diroximel fumarate capsule". DailyMed. 30 March 2020. Retrieved 30 June 2020.
  10. ^ "Drug Approval Package: Vumerity". U.S. Food and Drug Administration (FDA). 21 April 2020. Retrieved 30 June 2020.
  11. ^ World Health Organization (2020). "International nonproprietary names for pharmaceutical substances (INN) : recommended INN: list 80" (PDF). WHO Drug Information. 34 (1): 74.

External links[edit]