Epalrestat cannot lower blood sugar, but many diabetics are using it, why?

A friend with diabetes told Hua Zi that there are many diabetic friends around him who are using epalrestat, but this drug cannot lower blood sugar, why is everyone using it? Do you need to use it?

Hua Zi said that epalrestat has a special status in the treatment of diabetes. Although it cannot lower blood sugar, it can prevent and treat complications such as peripheral neuropathy and diabetic foot caused by diabetes. It has a therapeutic effect on vascular disease and kidney disease caused by diabetes, so doctors will recommend long-term use for diabetic patients who are at risk of complications.

One, the damage of high blood sugar to the body

The damage mechanism of hyperglycemia to the human body has a theory of “sorbitol accumulation”. When the human blood sugar is normal, the main metabolic pathway of glucose is through aerobic metabolism to generate carbon dioxide and water or anaerobic glycolysis to generate lactic acid, and at the same time to provide energy for the body.

But when blood sugar is too high, a large amount of glucose will undergo bypass metabolism and be converted into sorbitol through the action of aldose reductase. The accumulation of sorbitol in nerve cells and epithelial cells will cause toxic reactions and lead to apoptosis, which will lead to nerve and blood vessel damage and induce various diabetes complications.

Therefore, if diabetic patients control their blood sugar well, they can reduce the production of sorbitol and avoid or reduce the complications of diabetes.

Second, what is the role of epalrestat

Epalrestat is currently the only drug that can inhibit aldose reductase, which can reduce the glucose bypass metabolism in hyperglycemia and reduce sorbitol generation.

SoEpalrestat can reduce the toxic reaction caused by the accumulation of sorbitol, reduce cell damage, promote cell self-repair, and improve subjective symptoms and neurological function It has a good therapeutic effect on vascular disease and neuropathy caused by diabetes.

Epalrestat can be used to prevent complications in those with poor long-term control of blood sugar and high risk of diabetic complications.

Patients with diabetes who have developed complications, such as peripheral neuropathy (numbness in hands and feet, chills, paresthesia, etc.), diabetic foot, cardiac autonomic nerve damage (arrhythmia, palpitation, chest tightness, etc.) ), diabetic vascular damage, diabetic nephropathy, etc., the use of epalrestat has a therapeutic effect.

But everyone should understand that although epalrestat reduces sorbitol and prevents complications, the core of diabetes treatment is to control blood sugar.

Three, what to pay attention to when using epalrestat

1. Take the medicine before meals: The usual dose is 50 mg each time, 3 times a day, before meals. The elderly and those with liver and kidney insufficiency should reduce the dose as appropriate.

2. Effects on liver and kidney: After oral absorption of epalrestat, it is mainly distributed in the digestive tract, liver and kidney, and liver and kidney functions may occur. Abnormal, occasionally increased bilirubin, transaminases (AST, ALT), and creatinine. Overdose is not recommended to avoid liver and kidney damage.

3. Urine discoloration: The metabolites of epalrestat will be excreted through the kidneys, and urine will appear reddish brown during administration >, don’t worry if you see abnormal urine color, it can return to normal after stopping the drug. Urine while taking the medicineElevated bilirubin and ketone bodies will interfere with urine tests. When doing urine-related tests, you should explain the situation to your doctor.

4. Adverse reactions: Occasional allergic reactions such as erythema, rash, itching, etc. If allergic reactions occur, the drug should be discontinued. It may cause gastrointestinal reactions such as diarrhea, nausea, vomiting, loss of appetite, etc., but the reactions are usually mild and do not affect the medication, and can return to normal after stopping the medication. Headache, dizziness, fatigue, drowsiness and other adverse reactions are rare.

To sum up, although epalrestat cannot lower blood sugar, it can reduce the production of sorbitol and has a good preventive effect on diabetic complications. People with substandard blood sugar control, potential risk of diabetic complications or those who have already developed diabetic complications can take epalrestat for a long time to prevent and treat a variety of diabetic complications. The drug should be used under the guidance of a doctor. If you have any doubts about the drug, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.