After a therapeutic dose, a large fraction (30-44%) of acetaminophen (APAP) can be converted to inactive sulfate conjugates. Cytosolic sulfotransferases (SULTs) carry out the sulfation conjugation of APAP. SULTs transfer a sulfo group from PAPS to APAP, making it more polar and therefore easier to eliminate. SULTs 1A1, 1A3, 1A4, 1C4, 1E1 and 2A1 are known to have sulfotransferase activity towards APAP (Reiter & Weinshilboum 1992, Adjei et al. 2008, Mazaleuskaya et al. 2015). SULTs are expressed in many tissues but Yamamoto et al. found higher sulfating activity in the liver and intestine than that found in the lung and kidney (Yamamoto et al. 2015).
sulfotransferase activity of SULT dimers (APAP) [cytosol]