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Medications that stimulate the CYP system can predispose patients to APAP hepatotoxicity by causing enhanced production of NAPQI via the oxidative pathway.25 Case series reports have concluded that in 50% of adult patients with APAP-induced acute liver failure, the life-threatening condition was preceded by ingestion of potentially hepatotoxic herbs within 8 weeks of hospital presentation.4 The prescription agents known for their hepatotoxic tendencies include anti-epileptic drugs, such as phenobarbital, phenytoin and carbamazepine, as well as anti-tuberculosis drugs, such as isoniazid and rifampin

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