ReviewOpen access emergency medicine : OAEM2011
Does cytochrome P450 liver isoenzyme induction increase the risk of liver toxicity after paracetamol overdose?
Review in Open access emergency medicine : OAEM, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 54 citations in OpenAlex.
- Mechanistic insights into hepatic cell type-specific contributions to acetaminophen-induced acute liver injury.World journal of gastroenterology · 2025Review
- Article
- The effects of alpha-pinene against paracetamol-induced liver damage in male rats.Physiological reports · 2025Article
- Maturation of Paracetamol Elimination Routes in Preterm Neonates Born Below 32 Weeks of Gestation.Pharmaceutical research · 2023Article
- Acetaminophen-induced liver injury: Molecular mechanism and treatments from natural products.Frontiers in pharmacology · 2023Review
- Evaluation of the Association between Single Nucleotide Polymorphisms of Metabolizing Enzymes with the Serum Concentration of Paracetamol and Its Metabolites.Metabolites · 2022Article
- "Chemical research in toxicology · 2022Review
- Chemical Composition and Antioxidant Activity ofAntioxidants (Basel, Switzerland) · 2022Article
- Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse.Journal of clinical medicine · 2021Review
- Loss of BOK Has a Minor Impact on Acetaminophen Overdose-Induced Liver Damage in Mice.International journal of molecular sciences · 2021Article
- Hepatoprotective Effect of A Polyherbal Extract Containing Andrographis Paniculata, Tinospora Cordifolia and Solanum Nigrum Against Paracetamol Induced Hepatotoxicity.Pharmacognosy magazine · 2015Article
- Lycium barbarum extract provides effective protection against paracetamol-induced acute hepatotoxicity in rats.International journal of clinical and experimental medicine · 2015Article
- Understanding a substrate's product regioselectivity in a family of enzymes: a case study of acetaminophen binding in cytochrome P450s.PloS one · 2014Article
- Impact of amending the acetylcysteine marketing authorisation on treatment of paracetamol overdose.ISRN toxicology · 2013Article
- Paracetamol (acetaminophen) overdose and acetylcysteine administration: should the United Kingdom adopt a single '150-line'?British journal of clinical pharmacology · 2012Article
- Paracetamol toxicity: What would be the implications of a change in UK treatment guidelines?European journal of clinical pharmacology · 2012Article
- A review of the evidence concerning hepatic glutathione depletion and susceptibility to hepatotoxicity after paracetamol overdose.Open access emergency medicine : OAEM · 2011Review
- The Potential Protective Effect of Curcumin and α-Lipoic Acid on N-(4-Hydroxyphenyl) Acetamide-induced Hepatotoxicity Through Downregulation of α-SMA and Collagen III Expression.Dose-response : a publication of International Hormesis SocietyArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Paracetamol (acetaminophen, N-acetyl-p-aminophenol, 4-hydroxyacetanilide) is the most common cause of acute liver failure in developed countries. There are a number of factors which potentially impact on the risk of an individual developing hepatotoxicity following an acute paracetamol overdose. These include the dose of paracetamol ingested, time to presentation, decreased liver glutathione, and induction of cytochrome P450 (CYP) isoenzymes responsible for the metabolism of paracetamol to its toxic metabolite N-acetyl-p-benzoquinoneimine (NAPQI). In this paper, we review the currently published literature to determine whether induction of relevant CYP isoenzymes is a risk factor for hepatotoxicity in patients with acute paracetamol overdose. Animal and human in vitro studies have shown that the CYP isoenzyme responsible for the majority of human biotransformation of paracetamol to NAPQI is CYP2E1 at both therapeutic and toxic doses of paracetamol. Current UK treatment guidelines suggest that patients who use a number of drugs therapeutically should be treated as "high-risk" after paracetamol overdose. However, based on our review of the available literature, it appears that the only drugs for which there is evidence of the potential for an increased risk of hepatotoxicity associated with paracetamol overdose are phenobarbital, primidone, isoniazid, and perhaps St John's wort. There is no evidence that other drugs often quoted as increasing risk, such as carbamazepine, phenytoin, primidone, rifampicin, rifabutin, efavirenz, or nevirapine, should be considered risk factors for hepatotoxicity in patients presenting with acute paracetamol overdose.
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