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CYP2D6 may also contribute to the formation of NAPQI, albeit to a lesser extent than other P450 isozymes, and its activity may contribute to paracetamol toxicity, in particular, in extensive and ultrarapid metabolizers and when paracetamol is taken at very large doses.[18] The metabolism of paracetamol is an excellent example of toxication, because the metabolite NAPQI is primarily responsible for toxicity rather than paracetamol itself

Reprod Toxicol 111:110 Yin D, Zhong Y, Ling S, Lu S, Wang X, Jiang Z (2024) Dendritic-cell-targeting virus-like particles as potent mRNA vaccine carriers

however, the results available so far require independent corroboration

Its mechanism of action is related to its ability to shuttle fatty acids into the mitochondria, where they are converted into ATP, the energy currency of the body