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Hence NAC works as a glutathione donor preventing NAPQI accumulation Paracetamol metabolism diagram Toxicokinetics: Well absorbed from the small intestine Peak concentration 1-2 hours post ingestion (30 mins for liquid) Small volume of distribution 0.9 L/kg Hepatic metabolism and renal excretion as shown above

When lactate becomes excessive in the brain, the BBB enhances lactate efflux to prevent harmful accumulation

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However, given that visual stabilisation was observed in a proportion of participants in the LEROS study, it may be useful for future studies to explore whether idebenone modifies the risk of developing vision loss by increasing mitochondrial reserve, especially in individuals who would be at higher risk such as males or those with exposure to external metabolic stressors that disrupt OXPHOS

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