Azathioprine

Azathioprine (Imuran) is a cytotoxic agent that preferentially destroys any rapidly dividing cell. Since im-munologically competent cells are generally rapidly dividing cells, azathioprine is very effective as an immunosuppressive drug. Unfortunately, any cell that is replicating is a target for this action. This lack of specificity leads to serious side effects.

Azathioprine, in combination with corticosteroids, has historically been used more widely than any other drug in immunosuppressive therapy. It is classified as a purine antimetabolite and is a derivative of 6-mercap-topurine (see Chapter 56).

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