A 52-year-old woman comes to the physician because of a 1-day history of severe pain and swelling of her left great toe. Medical history is significant for kidney transplant due to focal segmental glomerulosclerosis. The patient is diagnosed with gout and treated with an appropriate drug. Six weeks later, the patient is seen at follow-up. She has no foot pain and the swelling has subsided. Serum uric acid level is 13.5 mg/dL and creatinine level is 0.9 mg/dL. Allopurinol is prescribed. Initiation of this drug would most likely increase the activity of which of the following medications?

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Eductional Objective: Azathioprine is an immunosuppression drug that is metabolized into active metabolites by HGPRT and, conversely, inactivated by xanthine oxidase. Coadministration with a xanthine oxidase inhibitor (eg, allopurinol, febuxostat) shunts azathioprine metabolism toward the production of active metabolites, resulting in increased immunosuppression and risk of cellular toxicity

A 52-Year-Old Woman Comes to the Physician Because of a 1-Day