06/23/2026
Have you or someone you love been prescribed azathioprine, mercaptopurine, or thioguanine?
These medications, used for Crohn's disease, ulcerative colitis, rheumatoid arthritis, organ transplant rejection, and certain childhood leukemias, can be very effective. But for some people, there is a serious risk of bone marrow suppression based on how their bodies process them genetically.
CPIC, the gold-standard organization for pharmacogenomics guidelines, just released a major update: the 2025 Thiopurine Dosing Guideline. The big news is that patients who carry genetic variants in both TPMT and NUDT15 (two enzymes that break down these medications) now have their own specific dosing guidance for the first time.
Previously, people in that "double intermediate" category didn't have a clear recommendation. Now they do: a greater dose reduction than either gene alone would suggest, which may help protect against serious side effects.
The update also provides clearer, drug-by-drug guidance, so prescribers can make more precise decisions based on both the patient's genetics and their specific condition.
At MedGenyx, we specialize in exactly this kind of personalized medication guidance. A simple genetic test could reveal whether standard doses of these medications pose a risk before any harm occurs.
Curious whether this applies to you or a family member?
Book a Free Discovery Call → https://medgenyx.practicebetter.io/ #/62f1a6008b0c27addd549003/bookings?r=6338a1f6c97de21f47f64e47