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Methylene blue treatment was first used in 1891 when German physician and Nobel laureate Paul Ehrlich explored methylene blues use as a staining agent and potential therapeutic compound

Although GSH extrusion may provide a simple mechanism to circumvent the normally protective functions of GSH, there is increasing evidence that GSH export is required for activation of specific apoptotic signaling pathways and/or for proper dismantling of cellular components (Coppola and Ghibelli, 2000

While this approach might similarly reduce liver injury in APAP overdose patients, it would require administration soon after the overdose which is a time where NAC is well established to be safe and highly efficacious

These factors increase operational costs, which are passed on in pricing