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If irritation continues to occur, apply an over-the-counter itch cream, preferably with hydrocortisone, or discontinue use

10.1002/cssc.202202277 ChemSusChem 9 BaroneG.Rodrguez-SeijoA.ParatiM.JohnstonB.ErdemE.CernavaT.et al (2024)

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with direct glucuronidation (~55%) and sulfation (~40%) (Mitchell et al., N -acetyl p -benzoquinone imine (NAPQI), a highly reactive electrophile, which is known to covalently bind to nucleophilic centers, including cysteine thiols in liver proteins (see Figure 1) (Jollow et al., 1973), with CYP1A2, 2D6, 2E1, and 3A4 isoforms as the major APAP oxidizing enzymes (Raucy et al., 1989