azathioprine + mycophenolate mofetil + methotrexate

This is a combination of three immunosuppressive drugs—azathioprine (a purine analog), mycophenolate mofetil (a prodrug of mycophenolic acid and an inosine monophosphate dehydrogenase inhibitor), and methotrexate (an antifolate antimetabolite). All three agents are used to suppress the immune system in various autoimmune diseases and to prevent organ transplant rejection. Azathioprine inhibits purine metabolism and nucleic acid synthesis to reduce lymphocyte proliferation[7][3]. Mycophenolate mofetil inhibits inosine monophosphate dehydrogenase 1 and 2, blocking guanosine nucleotide synthesis required for DNA/RNA production in lymphocytes[4]. Methotrexate inhibits dihydrofolate reductase and other enzymes involved in nucleotide synthesis, preventing cell division especially in rapidly dividing immune cells[6]. This combination may be considered for difficult-to-treat autoimmune or inflammatory conditions when single-agent therapy is insufficient[1][5].

Other names

AZAMMFMTX