What are the major side effects associated with antimetabolites?

Antimetabolites are a class of chemotherapy drugs that interfere with the DNA synthesis of rapidly dividing cells, which is characteristic of cancer cells. However, because these drugs also affect normal cells, especially those with high turnover rates, a key side effect is bone marrow suppression. This occurs because the bone marrow is responsible for producing blood cells, and when it is suppressed, it can lead to conditions such as anemia, increased risk of infections, and bleeding due to low platelet counts.

Additionally, mucositis is another significant side effect associated with antimetabolites. This refers to the inflammation and ulceration of the mucous membranes lining the digestive tract, leading to painful sores in the mouth and throat, which can cause difficulties in eating and swallowing. The development of mucositis is particularly common in patients receiving treatments that target rapidly dividing cells, including those in the gastrointestinal tract.

These two effects—bone marrow suppression and mucositis—are central to the adverse reactions one might expect when administering antimetabolites, making this answer the most comprehensive choice among the options provided. Other side effects mentioned in the other options, while notable in other classes of chemotherapeutic agents, are not the primary concerns specifically associated with antimetabolites.