Acetaminophen is another common OTC medication used for pain. Chronic alcohol consumption induces CYP2E1, increasing the formation of the hepatotoxic acetaminophen metabolite NAPQI (293). Oneta et al. demonstrated that acute ethanol ingestion increased NAPQI formation by 20% in heavy drinkers, emphasizing the danger of acetaminophen use in this population (294). Though acute alcohol use temporarily inhibits CYP2E1, excessive alcohol consumption shortly before acetaminophen use still increases liver damage risk (295).
