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Acetaminophen metabolism. NAPQI, N acetyl p benzoquinone imine; CYP450, Download Scientific Diagram Alcohol and paracetamol are both processed through the liver. Paracetamol can form a toxic metabolite called NAPQI, which the body usually neutralises safely. But factors like heavy alcohol use, repeated dosing, fasting Interaction with Ethanol Alcohol Metabolism Acetaminophen NAPQI Hepatotoxicity: A Cell Line Model System Genome Wide Association Study PMC Full article: Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease A 48 hour fast can turn standard Paracetamol into acute liver failure. Fasting depletes Glutathione, leaving the liver defenseless against toxic NAPQI. Review the latest guidelines on BMJ Best Practice: https: bestpractice.bmj.com topics en us 1010
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