It is metabolised into non-toxic, inactive molecules by the liver using a couple of different pathways which cope just fine with doses in the recommended range. It also acts to reduce fever, so stopping the production of some of the peptides that promote both pain and fever would seem the likeliest way for it to work. Paracetamol produces mild to moderate analgesia in a relatively short time frame by a mechanism that is still not determined.
Bear with me and you’ll see why I say this. Strangely enough I still think paracetamol can justifiably be called a safe drug. The toxicity of paracetamol is well-known in medical circles, and is certainly familiar to the majority of people who use it a lot. It is remarkable for a number of reasons, not least of which was the fact that it took 2 reporters a couple of years and $750,000 to do it. The story was about what seemed to the reporters to be a massive coverup of the toxicity of acetaminophen, which is the US spelling of paracetamol. This apparently scandalous story was brought to my attention this week.
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