Acetaminophen metabolism Acetaminophen (Paracetamol) Toxicity A common and potentially fatal cause of acute liver failure due to toxic accumulation of the metabolite NAPQI when glutathione stores are depleted. Early recognition and timely administration An Example of a Drug That Causes Toxicity Through the Formation of a Chemically Reactive Intermediate Mechanisms of Adverse Drug Reactions Pharmacovigilance 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, NAPQI Alchetron, The Free Social Encyclopedia