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In addition, the glutamine metabolism, via TCA cycle, promotes action of NADP + -dependent enzyme, which increases NADPH production, consequently increasing the GSH/GSSG (glutathione reduced/glutathione oxidized) ratio [7]

10.1146/annurev-physiol-042022-031925 35 XianX.XuM.YuH.WangL.LiX.RakJ.et al (2021)

Even with excellent clinical trial safety data, individual responses may vary

When cyp2e1 knockout mice that lack the ability to produce the CYP2E1 enzyme were challenged with acetaminophen, they were found to be considerably less sensitive to its hepatotoxic effects than wild-type animals, indicating that this CYP is the principal enzyme responsible for the metabolic conversion of the drug acetaminophen to its active hepatotoxic metabolite NAPQI (Figure 2)

In humans, the initial symptoms are nausea, fatigue, and diarrhea