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Indeed, 50% of ALF cases in the USA and Europe are due to drug exposure with 80% of these cases relating to APAP overdose and the remaining 20% to injury from drugs other than APAP where the drug was taken at the prescribed dose.63 DILI due to APAP is an inevitable consequence if sufficient drug is consumed and there is no medical intervention but it remains possible that some individuals are more susceptible to this toxicity than others, especially at lower levels of overdose