Epalrestat tablets and methylcobalamin tablets have different pharmacological effects and are usually not comparable, but methylcobalamin tablets have a wider scope of application than Epalrestat, and both need to be selected according to the condition as prescribed by the doctor. Epalrestat tablets is a kind of aldose reductase inhibitor, can inhibit the accumulation of sorbitol in the erythrocytes of diabetic peripheral neuropathy people, can improve the self-awareness of symptoms as well as neurological dysfunction. It is used for diabetic neuropathy. Adverse reactions to Epalrestat tablets can be seen as erythema, rash, blisters, pruritus, elevated bilirubin and transaminases, nausea and vomiting. It is contraindicated in people who are allergic to this product. Methylcobalamin tablets belong to the endogenous coenzyme B12, which has an inhibitory effect on drug-induced neurodegeneration and is indicated for peripheral neuropathy. Adverse reactions such as vomiting, diarrhea, loss of appetite and nausea can be seen with this product, and it is contraindicated for those who are allergic to this drug. Epalrestat tablets are only suitable for diabetes-induced peripheral neuropathy, while methylcobalamin tablets are not limited to diabetes-induced peripheral neuropathy, which has a wider scope of application. It is recommended that patients use the above two drugs under the guidance of the doctor according to the condition, and strictly follow the doctor’s instructions to use the drugs, do not take them blindly, so as not to cause adverse consequences.