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van Ganzewinkel C, Derijks L, Anand KJ et al , Multiple intravenous doses of paracetamol result in a predictable pharmacokinetic profile in very preterm infants

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Because the milligram amount is fixed, a lighter body gets more drug exposure per pound: roughly 22% more at 70 kg and about a third less at 120 kg, compared with a 90 kg reference. The dose still comes from response and tolerability, but a lighter person is running a hotter exposure at the same number on the vial

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However, the proposed lactate-acidification-ferroptosis axis warrants careful evaluation in light of emerging contradictory evidence