Drug & supplement interaction

Quillaia + Diroximel Fumarate

Diroximel Fumarate brand name: Vumerity.

Moderate Interaction
The bottom line Moderate

Quillaia has a moderate interaction with Diroximel Fumarate. Theoretically, concomitant use of quillaia with immunosuppressant drugs might decrease the effectiveness of these drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Quillaia and Diroximel Fumarate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Diroximel Fumarate

Diroximel Fumarate falls under IMMUNOSUPPRESSANTS — the group Quillaia interacts with.

Theoretically, concomitant use of quillaia with immunosuppressant drugs might decrease the effectiveness of these drugs.
In vitro research shows that some quillaia constituents have immunostimulant effects.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the idea behind pairing quillaia with Vumerity (diroximel fumarate). Vumerity calms down an overactive immune system to help control your MS. In lab dish studies, certain saponins in quillaia seemed to do the opposite and nudge the immune system to be a little more active. On paper, that could work against what your MS medicine is trying to do, possibly making it less effective at preventing flare-ups.

I want to be honest with you: this is a theoretical concern based only on lab research, not on real patients. The everyday food amounts of quillaia (like in some foamy drinks) are very unlikely to matter. Concentrated herbal supplement doses are the bigger question mark. Before adding a quillaia supplement, just run it by your pharmacist or neurologist so nothing undercuts your treatment.

References
  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  3. Wu JY, Gardner BH, Murphy CI, et al. Saponin adjuvant enhancement of antigen-specific immune responses to an experimental HIV-1 vaccine. J Immunol 1992;148:1519-25. DOI
  4. Fleck JD, Betti AH, da Silva FP, et al. Saponins from Quillaja saponaria and Quillaja brasiliensis: particular chemical characteristics and biological activities. Molecules 2019;24(1). pii: E171. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Quillaia Also Interacts With Other Medications

Quillaia has 120 moderate known drug interactions in our database — the Diroximel Fumarate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Quillaia

Covers the 2,830 medications we’ve checked against Quillaia. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Diroximel Fumarate

This page covers Quillaia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diroximel Fumarate page lists 106 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Active Hexose Correlated Compound (ahcc) (moderate).

By severity: 4 major · 92 moderate · 10 minor.

From our pharmacist’s overview on the Diroximel Fumarate page

“Diroximel fumarate (Vumerity) treats relapsing multiple sclerosis by quieting an overactive immune system, and I read its interaction list with real seriousness. Four of the 106 entries rate major, and none are exotic.”

Reviewed by 2 · Jul 18, 2026

Open the Diroximel Fumarate interaction page

How much people look this up

Where Quillaia and Diroximel Fumarate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Quillaia
Top half

#650 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Diroximel Fumarate
Top 25%

#291 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Quillaia

What is Quillaia?

  • Cough and chest congestion
  • Foaming agent in beverages
  • Vaccine adjuvant (in pharmaceutical manufacturing)
  • Washing and cleansing (traditional soap)
  • Skin conditions

Quillaia (soap bark tree) is a plant whose bark contains foaming compounds called saponins, and it is widely used as an emulsifier in foods and drinks. As a supplement or herbal remedy its benefits are not well proven, and large amounts can be irritating or toxic, so it should be used cautiously and only as directed.

Read the full Quillaia monograph & all interactions
Medication

About Diroximel Fumarate

What Is Diroximel Fumarate Used For?

Brand name: Vumerity

Vumerity (diroximel fumarate) is used to treat relapsing forms of multiple sclerosis (MS) in adults. This includes three specific types: clinically isolated syndrome (a first MS episode), relapsing-remitting MS (the most common pattern of flares and recovery), and active secondary progressive MS (a later stage where disability gradually worsens but relapses still occur).

See full Diroximel Fumarate drug information
Keep checking

Other Drugs & Quillaia

Browse every other medication we’ve checked against Quillaia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
120Moderate
0Minor
2,709No known interaction
Moderate

120 interactions

Showing 60 of 120 moderate interactions — see all 120 on the Quillaia page.

No interaction 2,709 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Quillaia and Diroximel Fumarate Together: Common Questions

Can you take Quillaia with Diroximel Fumarate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Quillaia and Diroximel Fumarate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.