GSH reduces NAPQI, the metabolite responsible for hepatotoxicity in acetaminophen toxicity. Toxic doses increase oxidation into NAPQI, overwhelming glutathione. How does ethanol interfere with acetaminophen metabolism? Image: https: t.co 6EY9dIwLXY NAPQI (N Acetyl 4 benzoquinone Imine) Acetaminophen Metabolite MedChemExpress 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, Haggling with HAGMA: A Common Medication with an Uncommon Differential Renal Fellow Network TYLENOL [Aetaminophen] metabolism Cyp 3A4 and 2E1: CYP3A4 is the major Cytochrome P 450 [Cyp] enzyme that catalyzes acetaminophen oxidation into NAPQI in human Phase I liver detox. The other Cyp enzyme Tylenol, Autism, And The Glutathione Connection OC Integrative Medicine