How to use Vumerity 231 Mg Capsule,Delayed Release Multiple Sclerosis Agents, General Read the Patient Information Leaflet if available from your pharmacist before you start taking diroximel fumarate and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication by mouth with or without food as directed by your doctor, usually twice daily. Swallow the capsules whole. Do not crush, chew, or sprinkle the capsule contents on food. Doing so can release all of the drug at once, increasing the risk of side effects. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose for the first 7 days, and then may increase your dose. Follow your doctor?s instructions carefully. If flushing occurs, taking this medication with food, or taking a plain (non-enteric coated) aspirin 30 minutes before your dose, may lessen this effect. If you take it with food, do not take it with a high-fat, high-calorie meal/snack (more than 700 calories and more than 30 grams fat). Also, do not drink alcohol with your dose of medication. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Tell your doctor if your condition gets worse.