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AM404 acts on the transient receptor potential vanilloid 1 (TRPV1) and cannabinoid 1 (CB1) receptors in the midbrain and medulla ( in vivo and in vitro whole-cell patch-clamp recordings with rats, wherein the acetaminophen metabolite AM404 directly induces analgesia via TRPV1 receptors on the spinal dorsal horn ( Acetaminophen does not possess any anti-inflammatory activity, because it is a very weak inhibitor of COX and does not inhibit neutrophil activation ( The purpose of this review was to summarize the previous and new issues related to the analgesic mechanisms of acetaminophen and discuss our understanding that acetaminophen metabolite AM404 also acts on the spinal dorsal horn and induces analgesia in inflammatory pain conditions

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none of it has been demonstrated in humans