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In some individuals, usually adults, acetaminophen can induce a high-anion-gap metabolic acidosis secondary to 5-oxoproline (ie, acquired pyroglutamic academia), possibly because of a genetically determined propensity (54

Surh YJ, Chun KS, Cha HH, Han SS, Keum YS, Park KK, et al

Change one variable at a time to isolate which compound is responsible for any changes in symptoms or blood markers

Under the FDAs Interim Policy on Compounding Using Bulk Drug Substances, the agency has stated that it does not intend to take enforcement action against pharmacies that compound with bulk drug substances listed in Category 1, provided the pharmacy otherwise complies with the conditions of section 503A