azathioprine + mesalazine

Azathioprine + mesalazine is a combination therapy used primarily in the management of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. Azathioprine is an immunosuppressive antimetabolite that inhibits purine synthesis, thereby suppressing T-lymphocyte proliferation. Mesalazine (also known as 5-aminosalicylic acid or 5-ASA) is an anti-inflammatory agent that acts locally in the colon to inhibit prostaglandin production via cyclooxygenase inhibition and modulate other inflammatory pathways. The combination can be effective for inducing or maintaining remission in patients with moderate to severe disease activity who are refractory to monotherapy. However, co-administration increases the risk of myelotoxicity due to pharmacokinetic interactions—mesalazine can inhibit thiopurine methyltransferase (TPMT), leading to higher levels of active thioguanines from azathioprine metabolism[1][2][3]. This necessitates careful monitoring for bone marrow suppression.

Other names

azathioprine and mesalazineazathioprine plus mesalazineazathioprine + mesalamineazathioprine and mesalamine