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Clinical Pharmacokinetics of Paracetamol

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Summary

In therapeutic doses paracetamol is a safe analgesic, but in overdosage it can cause severe hepatic necrosis. Following oral administration it is rapidly absorbed from the gastrointestinal tract, its systemic bioavailability being dose-dependent and ranging from 70 to 90%. Its rate of oral absorption is predominantly dependent on the rate of gastric emptying, being delayed by food, propantheline, pethidine and diamorphine and enhanced by metoclopramide. Paracetamol is also well absorbed from the rectum. It distributes rapidly and evenly throughout most tissues and fluids and has a volume of distribution of approximately 0.9L/kg. 10 to 20% of the drug is bound to red blood cells.

Paracetamol is extensively metabolised (predominantly in the liver), the major metabolites being the sulphate and glucuronide conjugates. A minor fraction of drug is converted to a highly reactive alkylating metabolite which is inactivated with reduced glutathione and excreted in the urine as cysteine and mercapturic acid conjugates. Large doses of paracetamol (overdoses) cause acute hepatic necrosis as a result of depletion of glutathione and of binding of the excess reactive metabolite to vital cell constituents. This damage can be prevented by the early administration of sulfhydryl compounds such as methionine and N-acetylcysteine.

In healthy subjects 85 to 95% of a therapeutic dose is excreted in the urine within 24 hours with about 4, 55, 30, 4 and 4% appearing as unchanged paracetamol and its glucuronide, sulphate, mercapturic acid and cysteine conjugates, respectively. The plasma half-life in such subjects ranges from 1.9 to 2.5 hours and the total body clearance from 4.5 to 5.5ml/kg/min. Age has little effect on the plasma half-life, which is shortened in patients taking anticonvulsants. The plasma half-life is usually normal in patients with mild chronic liver disease, but is prolonged in those with decompensated liver disease.

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References

  • Adriaenssens, P.I. and Prescott, L.F.: High performance liquid Chromatographic estimation of paracetamol metabolites in plasma. British Journal of Clinical Pharmacology 6: 87–88 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Alam, S.N.; Roberts, R.J. and Fischer, L.J.: Age-related differences in salicylamide and acetaminophen conjugation in man. Journal of Paediatrics 90: 130–135 (1977).

    Article  CAS  Google Scholar 

  • Andreasen, P.B. and Hutters, L.: Paracetamol (acetaminophen) clearance in patients with cirrhosis of the liver. Acta Medica Scandinavica 624 (Suppl.): 99–105 (1979).

    PubMed  CAS  Google Scholar 

  • Andrews, R.S.; Bond, C.G; Burnett, J.; Saunders, A. and Watsun, K.: Isolation and identification of paracetamol metabolites. Journal of International Medical Research 4 (Suppl. 4): 34–39 (1976).

    PubMed  CAS  Google Scholar 

  • Arnman, R. and Olsson, R.: Elimination of paracetamol in chronic liver disease. Acta Hepato-Gastroenterologica 25: 283–286 (1978).

    PubMed  CAS  Google Scholar 

  • Bagnall, W.E.; Kelleher, J.; Walker, B.E. and Losowsky, M.S.: The gastrointestinal absorption of paracetamol in the rat. Journal of Pharmacy and Pharmacology 31: 157–160 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Bajorek, P.; Widdop, B. and Volans, G.: Lack of inhibition of paracetamol absorption by codeine. British Journal of Clinical Pharmacology 5: 346–347 (1978).

    Article  CAS  Google Scholar 

  • Beaver, W.T.: Mild Analgesics. A review of the clinical pharmacology. American Journal of Medical Sciences 251: 576–599 (1966).

    Article  CAS  Google Scholar 

  • Briant, R.H.; Dorrington, R.E.; Cleal, J. and Williams, F.M.; The rate of acetaminophen metabolism in the elderly and the young. Journal of the American Geriatric Society 24: 359–361 (1976).

    CAS  Google Scholar 

  • Brodie, B.B. and Axelrod, J.: The estimation of acetanilide and its metabolic products, aniline, N-acetyl-p-aminophenol and p-aminophenol (free and total conjugated) in biological fluids and tissues. Journal of Pharmacology and Experimental Therapeutics 94: 22–28 (1948).

    PubMed  CAS  Google Scholar 

  • Brodie, B.B. and Axelrod, J.: The fate of phenacetin in man and methods for the estimation of phenacetin and its metabolites in biological materials. Journal of Pharmacology and Experimental Therapeutics 97: 58–67 (1949).

    PubMed  CAS  Google Scholar 

  • Buchanan, N. and Moodley, G.P.: Interaction between chloramphenicol and paracetamol. British Medical Journal 3: 307–308 (1979).

    Article  Google Scholar 

  • Buckpitt, S.R.; Rollins, D.E. and Mitchell, J.R.: Varying effects of sulphydryl nucleophiles on acetaminophen oxidation and sulphydryl adduct formation. Biochemical Pharmacology 28: 2941–2946 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Chiou, W.L: Estimation of hepatic first-pass effect of acetaminophen in humans after oral administration. Journal of Pharmaceutical Sciences 64: 1734–1735 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Clark, R.; Thompson, R.P.H.; Borirakenanyavat, U.; Widdop, S.; Davidson, A.R.; Goulding, R. and Williams, R.: Hepatic damage and death from overdose of paracetamol. Lancet 1: 66–69 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Clements, J.A. and Prescott, L.F.: Data point weighting in pharmacokinetic analysis; intravenous paracetamol in man. Journal of Pharmacy and Pharmacology 28: 707–709 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Clements, J.A.; Heading, R.C.; Nimmo, W.S. and Prescott, L.F.: Kinetics of acetaminophen absorption and gastric emptying in man. Clinical Pharmacology and Therapeutics 24: 420–431 (1978).

    PubMed  CAS  Google Scholar 

  • Crome, P.; Volans, G.N.; Vale, J.A.; Widdop, B. and Goulding, R.: Oral methionine in the treatment of severe paracetamol (acetaminophen) overdose. Lancet 2: 829–831 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Cummings, A.J.; King, M.L. and Martin, B.K.: A kinetic study of drug elimination. The excretion of paracetamol and its metabolites in man. British Journal of Pharmacology 29: 150–157 (1967).

    CAS  Google Scholar 

  • Davis, M.; Simmons, C.J.; Harrison, N.G. and Williams, R.: Paracetamol overdose in man-. Relationship between pattern of urinary metabolites and severity of liver damage. Quarterly Journal of Medicine 45: 181–191 (1976).

    PubMed  CAS  Google Scholar 

  • Dordoni, B.; Willson, R.A.; Thompson, R.P.H. and Williams, R.: Reduction of absorption of paracetamol by activated charcoal and cholestyramine: A possible therapeutic measure. British Medical Journal 3: 86–87 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Douglas, A.P.; Savage, R.L. and Rawlins, M.D.: Paracetamol (acetaminophen) kinetics in patients with Gilbert’s syndrome. European Journal of Clinical Pharmacology 13: 209–212 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Fevery, J. and de Groote, J.: Conjugation of N-acetyl-p-aminophenol (NAPA) in adult liver patients. Acta Hepato-Splenologica 16: 11–18 (1969).

    PubMed  CAS  Google Scholar 

  • Forfar, J.C.; Pottage, A.; Toft, A.D.; Irvine, W.J.; Clements, J.A. and Prescott, L.F.: Paracetamol pharmacokinetics in thyroid disease. European Journal of Clinical Pharmacology 18: 269–273 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Forrest, J.A.H.: Drug metabolism in liver disease. MD Thesis, University of Edinburgh (1980).

  • Forrest, J.A.H.; Finlayson, N.D.C.; Adjepon-Yamoah, K.K. and Prescott, L.F.: Antipyrine, paracetamol and lignocaine elimination in chronic liver disease. British Medical Journal 1: 1384–1387 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Forrest, J.A.H.; Adriaenssens, P.I.; Finlayson, N.D.C. and Prescott, L.F.: Paracetamol metabolism in chronic liver disease. European Journal of Clinical Pharmacology 15: 427–431 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Gazzard, B.C.; Ford-Hutchinson, A.W.; Smith, M.J.H. and Williams, R.: The binding of paracetamol to plasma proteins of man and pig. Journal of Pharmacy and Pharmacology 25: 964–967 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Gazzard, B.C.; Hughes, R.D.; Widdop, B.; Goulding, R.; Davis, M. and Williams, R.: Early prediction of the outcome of a paracetamol overdose based on an analysis of 163 patients. Postgraduate Medical Journal 53: 243–247 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Gerber, M.A.; Kaufmann, H.; Klion, F. and Alpert, L.I.: Report of two cases showing unusual portal tract reactions. Human Pathology 11: 37–42 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Glynn, J.P. and Bastian, W.: Salivary excretion of paracetamol in man. Journal of Pharmacy and Pharmacology 25: 420–421 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Goldfinger, R.; Ahmed, K.S.; Pitchumoni, C.S. and Weseley, S.A.: Concomitant alcohol and drug abuse enhancing acetaminophen toxicity. American Journal of Gastroenterology 70: 385–388 (1978).

    PubMed  CAS  Google Scholar 

  • Gwilt, J.R.; Robertson, A.; Goldman, L. and Blanchard, A.W.: The absorption characteristics of paracetamol tablets in man. Journal of Pharmacy and Pharmacology 15: 445–453 (1963a).

    Article  PubMed  CAS  Google Scholar 

  • Gwilt, J.R.; Robertson, A. and McChesney, E.W.: Determination of blood and other tissue concentrations of paracetamol in dog and man. Journal of Pharmacy and Pharmacology 15: 440–444 (1963b).

    Article  PubMed  CAS  Google Scholar 

  • Heading, R.C.; Nimmo, J.; Prescott, L.F. and Tothill, P.: The dependence of paracetamol absorption on the rate of gastric emptying. British Journal of Pharmacology 47: 415–421 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Holt, S.; Carter, D.C.; Heading, R.C.; Prescott, L.F. and Tothill, P.: Effect of gel fibre on gastric emptying and absorption of glucose and paracetamol. Lancet 1: 636–639 (1979a).

    Article  PubMed  CAS  Google Scholar 

  • Holt, S.; Heading, R.C.; McLoughlin, G.P and Prescott, L.F.; Paracetamol absorption in coeliac disease and Crohn’s disease. Gut 20: A449 (1979b).

    Google Scholar 

  • Howie, D.; Adriaenssens, P.I. and Prescott, L.F.: Paracetamol metabolism following overdosage. Application of high performance liquid chromatography. Journal of Pharmacy and Pharmacology 29: 235–257 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Jaffe, J.M.; Colaizzi, J.L. and Barry, H.: Effects of dietary components on GI absorption of acetaminophen tablets in man. Journal of Pharmaceutical Sciences 60: 1646–1650 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Jagenburg, R.; Nagy, A. and Rodjek, S.: Separation of p-acetaminophenol metabolites by gel filtration on Sephadex G10. Scandinavian Journal of Clinical and Laboratory Investigation 22: 11–16 (1968).

    Article  PubMed  CAS  Google Scholar 

  • JoUow, D.J.; Thorgeirsson, S.S.; Potter, W.Z.; Hashimoto, M. and Mitchell, J.R.: Acetaminophen-induced hepatic necrosis. VI. Metabolic disposition of toxic and non-toxic doses of acetaminophen. Pharmacology 12: 251–271 (1974).

    Article  Google Scholar 

  • Jones, D.P.; Sundby, G.B.; Ormstad, K. and Orrenius, S.: Use of isolated kidney cells for study of drug metabolism. Biochemical Pharmacology 28: 929–935 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Josting, D.; Winnie, D. and Bock, K.W.: Glucuronidation of paracetamol, morphine and l-naphthol in the rat intestinal loop. Biochemical Pharmacology 25: 613–616 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Klutch, A.; Levin, W.; Chang, R.L.; Vane, F. and Conney, A.H.: Formation of a thiomethyl metabolite of phenacetin and acetaminophen in dogs and man. Clinical Pharmacology and Therapeutics 24: 287–293 (1978).

    PubMed  CAS  Google Scholar 

  • Levy, G. and Houston, J.B.: Effect of activated charcoal on acetaminophen absorption. Pediatrics 58: 432–435 (1976).

    PubMed  CAS  Google Scholar 

  • Levy, G. and Yamada, H.: Drug biotransformation interactions in man. III: Acetaminophen and salicylamide. Journal of Pharmaceutical Sciences 60: 215–221 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Levy, G.; Khanna, N.N.; Soda, D.M.; Tsuzuki, O. and Stern, L.: Pharmacokinetics of acetaminophen in the human neonate: Formation of acetaminophen glucuronide and sulfate in relation to plasma bilirubin concentration and d-glucaric acid excretion. Pediatrics 55: 818–825 (1975).

    PubMed  CAS  Google Scholar 

  • Licht, H.; Seeff, L.B. and Zimmerman, H.J.: Apparent potentiation of acetaminophen hepatotoxicity by alcohol. Annals of Internal Medicine 92: 511, (1980).

    PubMed  CAS  Google Scholar 

  • Lowenthal, D.T.; Øie, S.; Van Stone, J.C.; Briggs, W.A. and Levy, G.: Pharmacokinetics of acetaminophen elimination by anephric patients. Journal of Pharmacology and Experimental Therapeutics 196: 570 (1976).

    PubMed  CAS  Google Scholar 

  • McClain, C.J.; Kromhout, J.P.; Peterson, F.J. and Holtzman, J.L: Potentiation of acetaminophen hepatotoxicity by alcohol. Journal of American Medical Association 244: 251–253 (1980).

    Article  CAS  Google Scholar 

  • McGilveray, I.J. and Mattock, G.L.: Some factors affecting the absorption of paracetamol. Journal of Pharmacy and Pharmacology 24: 615–619 (1972).

    Article  PubMed  CAS  Google Scholar 

  • McGilveray, I.J.; Mattock, G.L.; Fuchs, J.R.; Jordan, N. and Cook, D.: Acetaminophen II. A comparison of the physiological availabilities of different commercial dosage forms. Canadian Journal of Pharmaceutical Sciences 6: 38–42 (1971).

    CAS  Google Scholar 

  • Miller, R.P.; Roberts, R.J. and Fischer, L.J.: Acetaminophen elimination kinetics in neonates, children and adults. Clinical Pharmacology and Therapeutics 19: 284–294 (1976).

    PubMed  CAS  Google Scholar 

  • Miner, D.J. and Kissenger, P.T.: Evidence for the involvement of N-acetyl-p-quinoneimine in paracetamol metabolism. Biochemical Pharmacology 28: 3285–3290 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Mitchell, J.R.; Jollow, D.J.; Potter, W.Z.; Davis, D.C.; Gillette, J.R. and Brodie, B.B.: Acetaminophen-induced hepatic necrosis. I. Role of drug metabolism. Journal of Pharmacology and Experimental Therapeutics 187: 185–194 (1973).

    PubMed  CAS  Google Scholar 

  • Mitchell, J.R.; Thorgeirsson, S.S.; Potter, W.Z.; Jollow, D.J. and Reiser, H.: Acetaminophen-induced hepatic injury: Protective role of glutathione in man and rationale for therapy. Clinical Pharmacology and Therapeutics 16: 676–684 (1974).

    PubMed  CAS  Google Scholar 

  • Mitchell, J.R.; McMurtry, R.J.; Statham, C.N. and Nelson, S.D.: Molecular basis for several drug-induced nephropathies. American Journal of Medicine 62: 518–526 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Moes, A. and Jaminet, F.: Influence of ageing of suppositories on rectal absorption of paracetamol. Pharmaceutica Acta Helvetiae 51: 119–125 (1976).

    PubMed  CAS  Google Scholar 

  • Moolenaar, F.; Olthof, L. and Huizingat, T.: Absorption rate and bioavailability of paracetamol from rectal aqueous suspensions. Pharmaceutisch Weekblad 114: 201–206 (1979a).

    Article  Google Scholar 

  • Moolenaar, F.; Schoonen, A.J.M.; Everts, A. and Huizingat, T.: Absorption rate and bioavailability of paracetamol from fatty suppositories. Pharmaceutisch Weekblad 114: 689–694 (1979b).

    Article  Google Scholar 

  • Mrochek, J.E.; Katz, S.; Christie, W.H. and Dinsmore, S.R.: Acetaminophen metabolism in man as determined by high-resolution liquid chromatography. Clinical Chemistry 20: 1086–1096 (1974).

    PubMed  CAS  Google Scholar 

  • Mucklow, J.C.; Fraser, H.S.; Bulpitt, C.J.; Kahn, C.; Mould, G. and Dollery, C.T.: Environmental factors affecting paracetamol metabolism in London factory and office workers. British Journal of Clinical Pharmacology 10: 67–74 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Nelson, E. and Morioka, T.: Kinetics of the metabolism of acetaminophen by humans. Journal of Pharmaceutical Sciences 52: 864–868 (1963).

    Article  PubMed  CAS  Google Scholar 

  • Nimmo, W.S.: Drugs, diseases and altered gastric emptying. Clinical Pharmacokinetics 1: 189–203 (1976).

    Article  PubMed  CAS  Google Scholar 

  • Nimmo, W.S. and Prescott, L.F.: The influence of posture on paracetamol absorption. British Journal of Clinical Pharmacology 5: 348–349 (1978).

    Article  CAS  Google Scholar 

  • Nimmo, J.; Heading, R.C.; Tothill, P. and Prescott, L.F.: Pharmacological modification of gastric emptying: Effects of propantheline and metoclopramide on paracetamol absorption. British Medical Journal 1: 587–589 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Nimmo, W.S.; Heading, R.C.; Wilson, J.; Tothill, P. and Prescott, L.F.: Inhibition of gastric emptying and drug absorption by narcotic analgesics. British Journal of Clinical Pharmacology 2: 509–513 (1975a).

    Article  PubMed  CAS  Google Scholar 

  • Nimmo, W.S.; Wilson, J. and Prescott, L.F.: Narcotic analgesics and delayed gastric emptying during labour. Lancet 1: 890–893 (1975b).

    Article  PubMed  CAS  Google Scholar 

  • Nimmo, W.S.; King, I.S. and Prescott, L.F.: Paracetamol and aspirin absorption from Safapryn and Safapryn-Co. British Journal of Clinical Pharmacology 7: 219–220 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Øie, S.; Lowenthal, D.T.; Briggs, W.A. and Levy, G.: Effect of hemodialysis on kinetics of acetaminophen elimination by anephric patients. Clinical Pharmacology and Therapeutics 18: 680–686 (1975).

    PubMed  Google Scholar 

  • Perucca, E. and Richens, A.: Paracetamol disposition in normal subjects and in patients treated with antiepileptic drugs. British Journal of Clinical Pharmacology 7: 201–206 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Pottage, A.; Nimmo, J. and Prescott, L.F.: The absorption of aspirin and paracetamol in patients with achlorhydria. Journal of Pharmacy and Pharmacology 26: 144–145 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Prescott, L F.: The metabol ism of phenacetin in patients with renal disease. Clinical Pharmacology and Therapeutics 10 (Suppl. 2): 383–394 (1969).

    PubMed  CAS  Google Scholar 

  • Prescott, L.F.: Gastrointestinal absorption of drugs. Medical Clinics of North America 58: 907–916 (1974).

    PubMed  CAS  Google Scholar 

  • Prescott, L.F.: Kinetics and metabolism of paracetamol and phenacetin. British Journal of Clinical Pharmacology 10 (Suppl. 2): 291S–298S (1980).

    Article  PubMed  Google Scholar 

  • Prescott, L.F.; Wright, N.; Roscoe, P. and Brown, S.S.: Plasmaparacetamol half-life and hepatic necrosis in patients with paracetamol overdosage. Lancet 1: 519–522 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Prescott, L.F. and Wright, N.: The effects of hepatic and renal damage on paracetamol metabolism and excretion following overdosage. A pharmacokinetic study. British Journal of Pharmacology 49: 602–613 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Prescott, L.F.; Illingworth, R.N.; Critchley, J.A.J.H.; Stewart, M.J.; Adam, R.D. and Proudfoot, A.T.: Intravenous N-acetylcysteine: The treatment of choice for paracetamol poisoning. British Medical Journal 2: 1097–1100 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Prescott, L.F.; Critchley, J.A.J.H.; Balali-Mood, M. and Pentland, B.: Effects of microsomal enzyme induction on paracetamol in man. British Journal of Clinical Pharmacology 12: 149–153 (1981).

    PubMed  CAS  Google Scholar 

  • Proudfoot, A.T. and Wright, N.: Acute paracetamol poisoning. British Medical Journal 4: 557–558 (1970).

    Article  Google Scholar 

  • Rawlins, M.D.: Current therapeutic problems; in Prescott and Nimmo (Eds) Drug Absorption, pp.331–339 (ADIS, Sydney 1981).

    Google Scholar 

  • Rawlins, M.D.; Henderson, D.B. and Hijab, A.R.: Pharmacokinetics of paracetamol (acetaminophen) after intravenous and oral administration. European Journal of Clinical Pharmacology 11: 283–286 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Richter, A. and Smith, S.E.: Bioavailability of different preparations of paracetamol. British Journal of Clinical Pharmacology 1: 495–498 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Shamszad, M.; Soloman, H.; Morbarhan, S. and Iber, F.L.: Abnormal metabolism of acetaminophen in patients with alcoholic liver disease. Gastroenterology 69: 865 (1975).

    Google Scholar 

  • Shively, C.A. and Vessell, E.S.: Temporal variations in acetaminophen and phenacetin half-life in man. Clinical Pharmacology and Therapeutics 18: 413–424 (1975).

    PubMed  CAS  Google Scholar 

  • Slattery, J.T. and Levy, G.: Acetaminophen kinetics in acutely poisoned patients. Clinical Pharmacology and Therapeutics 25: 184–195 (1979).

    PubMed  CAS  Google Scholar 

  • Stewart, M.J.; Adriaenssens, P.I.; Jarvie, D.R. and Prescott, L.F.: Inappropriate methods for the emergency determination of plasma paracetamol. Annals of Clinical Biochemistry 16: 89–95 (1979).

    PubMed  CAS  Google Scholar 

  • Streeter, A.J. and Timbrell, J.A.: The effect of dichloralphenazone pretreatment on paracetamol hepatoxicity in mice. Biochemical Pharmacology 28: 3035–3037 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Strubelt, O.; Obermeier, F. and Siegers, C.P.: The influence of ethanol pretreatment on the effects of nine hepatotoxic agents. Acta Pharmacologica et Toxicologica 43: 211–218 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Teschke, R.; Stutz, G. and Strohmeyer, G.: Increased paracetamol-induced hepatotoxicity after chronic alcohol consumption. Biochemical and Biophysical Research Communications 91: 368–374 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Triggs, E.J.; Nation, R.L.; Long, A. and Ashley, J.: Pharmacokinetics in the elderly. European Journal of Clinical Pharmacology 8: 55–62 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Welch, R.M. and Conney, A.H.: Simple method for the quantitative determination of N-acetyl-p-aminophenol (APAP) in urine. Clinical Chemistry 11: 1064–1067 (1965).

    PubMed  CAS  Google Scholar 

  • Wiener, K.: A review of methods for plasma paracetamol estimation. Annals of Clinical Biochemistry 15: 187–196 (1978).

    PubMed  CAS  Google Scholar 

  • Wojcicki, J.; Gawronska-Szklarz, B.; Kazimierezyk, J.; Baskzewiez, Z. and Raezynski, A.: Comparative pharmacokinetics of paracetamol in men and women considering follicular and luteal phases. Arzneimmittel-Forschung 29: 350–352 (1979).

    CAS  Google Scholar 

  • Wright, N. and Prescott, L.F.: Potentiation by previous drug therapy of hepatotoxicity following paracetamol overdosage. Scottish Medical Journal 18: 56–58 (1973).

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Therapeutics and Clinical Pharmacology, The Royal Infirmary, Edinburgh, EHE 9YW, Scotland

    John A. H. Forrest, J. A. Clements & L. F. Prescott

  2. Department of Pharmacy, Heriot-Watt University, Edinburgh, UK

    John A. H. Forrest, J. A. Clements & L. F. Prescott

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Forrest, J.A.H., Clements, J.A. & Prescott, L.F. Clinical Pharmacokinetics of Paracetamol. Clin Pharmacokinet 7, 93–107 (1982). https://doi.org/10.2165/00003088-198207020-00001

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