What are the anti metabolites used for immunosuppression?
Inosine monophosphate dehydrogenase inhibitors (IMPDH inhibitors) inhibit purine synthesis.
Two important drugs in this class are MPA and MMF. MPA directly inhibits IMPDH (a key enzyme in purine synthesis), whereas MMF is a prodrug that releases MPA.
The principal side effects of these medications are gastrointestinal (nausea, vomiting, diarrhea) and hematologic (anemia, leukopenia).
Azathioprine inhibits interferes with DNA, RNA, and protein synthesis. It is an option for those patients who cannot tolerate the IMPDH inhibitors for reasons such as GI distress.