Acetaminophen NAPQI Toxicity RK.MD Acetaminophen metabolism explained "simply" Since it's been blowing up my feed this week (this is not considering metabolic fates changes when pregnant) Your liver normally clears acetaminophen (Apap) safely, but in overdose, its 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 An Example of a Drug That Causes Toxicity Through the Formation of a Chemically Reactive Intermediate Mechanisms of Adverse Drug Reactions Pharmacovigilance