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The heme compounds released may further promote oxidative damage especially when reducing compounds are present (Boveris et al., 2008)

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Methylene blue acts as a co-factor for nicotinamide adenine dinucleotide phosphate (NADPH)-dependent methemoglobin reductase, which leads to the formation of reduced methylthioninium chloride that can reduce ferric iron to ferrous iron needed to restore the oxygen-carrying capacity of hemoglobin

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