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. 2020 Apr 27;12(4):125–136. doi: 10.4254/wjh.v12.i4.125

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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

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Paracetamol metabolism pathways and breakdown into N-acetyl-p-benzoquinone imine, by cytochrome P450 2E1. N-acetyl-p-benzoquinone imine is the toxic metabolite produced from paracetamol metabolism when the other two conjugation pathways become over-saturated. The resultant toxic N-acetyl-p-benzoquinone imine byproduct is converted into nontoxic metabolites by glutathione, which is regenerated by N-acetylcysteine. NAPQI: N-acetyl-p-benzoquinone imine; CYP2E1: Cytochrome P450 2E1; NAC: N-acetylcysteine.