Indications
Epalrestat is used to relieve symptoms of diabetic peripheral neuropathy, nerve damage caused by long-term high blood sugar. It helps reduce numbness, tingling, burning pain and abnormal sensations in the hands and feet, and may help nerve function, particularly when used early alongside good blood sugar control.
How It Works
When blood sugar is high, an enzyme called aldose reductase turns extra glucose into sorbitol inside nerve cells. Sorbitol builds up and damages the nerves. Epalrestat blocks aldose reductase, which reduces sorbitol build-up and helps protect the nerves from further damage.
Dosage and Administration
Adults: usually 50 mg three times daily, taken before each main meal, or as prescribed. It is used for weeks to months, and the doctor will review whether it is helping. It does not replace treatment to control blood sugar.
Interactions
No major interactions are well documented. Tell your doctor about all medicines you take, including other medicines for nerve pain or diabetes, and herbal products.
Contraindications
- Allergy to Epalrestat or any ingredient.
- Use with caution or avoid in significant liver disease.
Side Effects
Side effects are usually mild: nausea, stomach discomfort, diarrhoea, loss of appetite, tiredness, dizziness and rash. Epalrestat often turns the urine yellow-brown or reddish, which is harmless. Rarely it can raise liver enzymes or cause liver problems, or a low platelet count.
Get urgent medical help if you notice yellowing of the skin or eyes, dark urine with pale stools, severe abdominal pain, unusual bruising or bleeding, or signs of allergy such as swelling of the face or difficulty breathing.
Pregnancy and Lactation
Safety in pregnancy and breastfeeding has not been established. Use only if a doctor considers the benefit greater than the risk; avoid breastfeeding during treatment unless advised otherwise.
Precautions and Warnings
- Liver function tests may be checked during treatment.
- Good blood sugar, blood pressure and foot care remain the most important parts of managing diabetic neuropathy.
- Check your feet daily for injuries, as numb feet may not feel cuts or blisters.
- Not recommended in children.
Overdose
Information on overdose is limited. Symptoms may include stomach upset and dizziness. Seek medical help if a large amount has been taken.
Therapeutic Class
Aldose reductase inhibitor (treatment for diabetic neuropathy).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.