metabolism of 1 4 butanediol and paracetamol

[Transcendence]

Do 1,4 butanediol and paracetamol share the same metabolic pathway in a way that would inhibit clearance of one another? Is tylenol hazardous in combination with BDO in the same way as with alcohol, or can they be safely combined in reasonable dosages?

 

[clubcard]

AFAIK the two compounds do not share the same metabolic fate. While BDO does undergo a similar set of oxidations, I would have thought that the potential risk of mixing two CNS depressants is a more important consideration.

 

[sekio]

BDO is oxidised by alcohol dehydrogenase rapidly to GHB (so quickly that it's undetectable after 20 mins or so) and then eventually to succinate, which enters the citric acid cycle and becomes CO2.

Paracetamol doesn;t interact with alcohol dehydrogenase at all.

 

[Skorpio]

I'd still be careful. Alcohol induces apap toxicity by inducing the cyp enzymes that metabolize apap into napqi (a super reactive fucker that attacks cysteines in liver proteins causing the toxicity, cyp2e1 and cyp3a4 to be exact). This lowers the dose where apap is toxic (it normally gets metabolized by glucuronidation and sulfation, until the enzymes get backlogged).

Since bdo is metabolized by the same route (ALDH) we don't know that it doesn't induce cyp enzymes over long term use, so I'd be careful combining the two over time.

Ethanol is a famously dirty drug, so odds are there isn't any cause for panic, but I would personally avoid taking too much apap on it (even a gram of apap on a virgin liver is enough to induce markers of damage).