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Clinical Chemistry 20: 1086-1096, 1974;
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Clinical Chemistry, Vol 20, 1086-1096, Copyright © 1974 by the American Association for Clinical Chemistry

Acetaminophen Metabolism in Man, as Determined by High-Resolution Liquid Chromatography

J. E. Mrochek 1, S. Katz 1, W. H. Christie 1, and S. R. Dinsmore 1

1 Oak Ridge National Laboratory,2 Oak Ridge, Tenn. 37830.

Acetaminophen is a commonly used analgesic, available without prescription. Several of its metabolites have heretofore been isolated from physiologic fluids and analytically characterized. In general, the separation methods are complicated, usually requiring extensive sample pretreatment, and do not measure the individual conjugated metabolites. High-resolution anionexchange separation of urinary samples from subjects receiving acetaminophen reveals eight chromatographic peaks, representing seven metabolites and the free drug itself. Metabolites separated include 2-methoxyacetaminophen, its glucuronide and sulfate conjugates, the sulfate conjugate of 2-hydroxyacetaminophen, the glucuronide and sulfate conjugates of acetaminophen, S-(5-acetamido-2-hydroxyphenyl)cysteine, and S-(5-acetamido-2-glucuronosidophenyl)cysteine. Urinary and serum concentrations of the drug and its seven metabolites were determined by high-resolution liquid chromatography as a function of time after two clinically normal men ingested 1950 mg of the drug. Concentrations in urine and serum are compared, and estimated urinary excretion rates are reported for all metabolites except S-(5-acetamido-2-hydroxyphenyl)cysteine. Serum concentrations of the glucuronide were higher than concentrations of the free drug 2 h after the drug was ingested, indicating that solvent-extraction procedures for serum will yield low estimates of total drug unless hydrolysis precedes the extraction step.


Key Words: detoxication mechanisms • drug and metabolites in serum and urine • toxicology • gas chromatography • mass spectrometry • S-(5-acetamido-2-glucuronosidophenyl) cysteine

Submitted on April 12, 1974
Accepted on June 3, 1974






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Copyright © 1974 by the American Association for Clinical Chemistry.