Paracetamol (Acetaminophen) hepatotoxicity and its management. 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, Simplified scheme of APAP metabolism, leading to the formation of NAPQI Download Scientific Diagram 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