Ipalrestat cannot lower blood sugar, but many diabetics are using it. Why?

A friend who suffers from diabetes told Huazi that many diabetic friends around him are using epalrestat, but this drug cannot lower blood sugar. Why are so many people using it? Does he need to use it?

Hua Zi said that epalrestat has a special position 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 also has a therapeutic effect on vascular lesions and kidney diseases caused by diabetes. Therefore, doctors will recommend diabetic patients at risk of complications to take it for a long time.

1. Damage of high blood sugar to the body

There is a theory of "sorbitol accumulation" about the mechanism of damage caused by high blood sugar to the human body. When the blood sugar level of the human body is normal, the main metabolic pathway of glucose is to produce carbon dioxide and water through aerobic metabolism or to produce lactic acid through anaerobic glycolysis, which also provides energy for the body.

However, when the blood sugar level in the human body is too high, a large amount of glucose will be metabolized by bypass and converted into sorbitol through the action of aldose reductase. The accumulation of sorbitol in nerve cells and epithelial cells will cause toxic reactions, leading to cell apoptosis , which will cause damage to nerves and blood vessels and induce various complications of diabetes.

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

What is the effect of epalrestat?

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

Therefore, epalrestat can reduce the toxic reactions caused by sorbitol accumulation , reduce cell damage, promote cell self-repair, improve subjective symptoms and neurological dysfunction, and has a good therapeutic effect on vascular lesions and neuropathy caused by diabetes.

For those with poor long-term blood sugar control and a higher risk of diabetic complications, epalrestat can be used to prevent the occurrence of complications .

Ipalrestat has a therapeutic effect on diabetic patients who have already developed complications, such as peripheral neuropathy (numbness, coldness, and abnormal sensation in the hands and feet), diabetic foot, cardiac autonomic nerve damage (arrhythmia, palpitations, chest tightness, etc.), diabetic vascular damage, diabetic nephropathy, etc.

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

3. What should I pay attention to when using epalrestat?

1. Take the medicine before meals : The regular dose is 50 mg each time, 3 times a day, before meals. The dosage should be reduced as appropriate for the elderly and those with liver and kidney dysfunction.

2. Effects on the liver and kidneys : After oral absorption, epalrestat is mainly distributed in the digestive tract, liver, and kidneys, which may cause liver and kidney dysfunction, and occasionally increase bilirubin, transaminase (AST, ALT), and creatinine. Overdose is not recommended to avoid liver and kidney damage .

3. Urine color change : The metabolites of epalrestat will be excreted from the body through the kidneys. The urine will be reddish brown during the medication period . Don't worry if you see abnormal urine color. It will return to normal after stopping the medication. During the medication period, the bilirubin and ketone bodies in the urine will increase, which will interfere with urine tests. When doing urine-related tests, you should explain the situation to your doctor.

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

In summary, although epalrestat cannot lower blood sugar, it can reduce the production of sorbitol and has a good preventive and therapeutic 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. Drugs must be used in a standardized manner under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.