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Azathioprine (AZA) metabolism. The initial step in mercaptopurine (6MP) nucleotide metabolite formation is catalysed by hypoxanthine phosphoribosyltransferase (HPRT). Further metabolism of mercaptopurine nucleotide results in the eventual formation of thioguanine nucleotides (TGNs). Oxidation catalysed by xanthine oxidase (XO), and methylation catalysed by thiopurine methyltransferase (TPMT), compete with TGN formation.
