cyclophosphamide or azathioprine

The term **cyclophosphamide or azathioprine** refers to two distinct immunosuppressive agents frequently utilized as alternatives or in sequence for the management of severe autoimmune and inflammatory conditions. **Cyclophosphamide** is a nitrogen mustard alkylating agent that functions by attaching alkyl groups to DNA, leading to intra-strand and inter-strand cross-linking which triggers apoptosis, particularly in rapidly proliferating lymphocytes. **Azathioprine** is a purine antimetabolite and a prodrug of 6-mercaptopurine; it exerts its effect by inhibiting de novo purine synthesis and by being incorporated into DNA and RNA, thereby disrupting nucleic acid synthesis and inhibiting T and B cell proliferation. In clinical practice, cyclophosphamide is often employed for induction therapy in life-threatening diseases like lupus nephritis or systemic vasculitis due to its potent but toxic nature, while azathioprine is commonly used for long-term maintenance therapy to prevent disease relapse.

Brand names

CytoxanNeosarImuranAzasanJayempiImurek

Other names

CyclophosphamideAzathioprineCPAZA6-mercaptopurine prodrug