Indications
Epalrestat consequently improves peripheral neuropathy due to sorbitol accumulation. It is usually used to improve numbness, pain and abnormality of vibration sensation/heart rate variability associated with diabetic peripheral neuropathy.
Therapeutic Class
Aldose reductase inhibitor
Pharmacology
Epalrestat is aldose reductase inhibitor. The aldose reductase inhibitors have a distinct mechanism of action, affecting the underlying disease process in diabetic neuropathy, although the extent of the polyol pathway involvement is yet to be determined. This medicine suppresses accumulation of sorbitol in cells by inhibiting action of aldose reductase which converts glucose of sugar to sorbitol. Epalrestat may improve motor and sensory nerve conduction velocity and subjective neuropathy symptoms.
Dosage & Administration
In general, for adults, take 1 tablet (50 mg of the active ingredient) at a time, 3 times a day before meals. The dosage may be adjusted according to your age and symptoms.
Interaction
There are no known drug interactions and none well documented.
Contraindications

    If you have previously experienced any allergic reactions (itch, rash, etc.) to any medicines.
    If you are pregnant or breastfeeding.
    If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.)

Side Effects
The most commonly reported adverse reactions include abdominal pain, nausea, rash, itch, erythema and blister.
Pregnancy & Lactation
Pregnancy category is not classified. FDA has not yet classified the drug into a specified pregnancy category
Precautions & Warnings
Your urinary color may turn yellowish brown or red due to color of the component of this medicine. Do not worry about the change.
Storage Conditions
Keep out of the reach of children. Store away from direct sunlight, heat and moisture.