Thiopuriines

Thiopurines are a class of drugs used primarily in the treatment of inflammatory bowel disease, particularly ulcerative colitis. They are also used in the treatment of rheumatoid arthritis and other autoimmune disorders. Thiopurines work by inhibiting the production of certain white blood cells, which are involved in the immune response. This helps to reduce inflammation and suppress the immune system.

The most commonly used thiopurines are azathioprine and mercaptopurine. Azathioprine is a prodrug that is converted into 6-mercaptopurine in the body, which is the active form of the drug. Mercaptopurine, on the other hand, is the active form of the drug and is used directly in the treatment of certain conditions.

Thiopurines are typically taken orally and have a long half-life, which means they can remain in the body for an extended period. This allows for once-daily dosing, which can be convenient for patients. However, the long half-life also means that it can take several weeks for the drug to reach its full effect, and it can take several weeks for the drug to be completely eliminated from the body after discontinuation.

Thiopurines can cause a number of side effects, including bone marrow suppression, which can lead to anemia, infection, and an increased risk of bleeding. They can also cause gastrointestinal side effects, such as nausea, vomiting, and diarrhea. In rare cases, thiopurines can cause serious liver toxicity.

Thiopurines are generally well-tolerated, but they can cause significant side effects in some patients. It is important for patients to discuss the potential benefits and risks of thiopurine therapy with their healthcare provider. Regular monitoring of blood counts and liver function is typically required to ensure the safe use of these drugs.