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A small amount of the drug is metabolized via the cytochrome P-450 pathway (to be specific, CYP3A4 and CYP2E1) into NAPQI, which is extremely toxic to liver tissue, as well as being a strong biochemical oxidizer

10.1038/342440a0 Nature 130 NaldiniL.TamagnoneL.VignaE.SachsM.HartmannG.BirchmeierW.et al (1992)

Methods and materials Study design and population This was an 8-week parallel-randomized controlled study involving 44 overweight or obese postmenopausal women with rheumatoid arthritis, conducted from May 2022 to March 2023, to evaluate inflammatory and oxidative stress markers, as well as liver enzymes

551,552 Furthermore, the Factor Inhibiting HIF-1 (FIH-1) disrupts the association between HIF-1 and the p300/CBP complex

Longer treatment durations up to several months have been examined in chronic disease models without apparent tolerance development or diminishing efficacy