Alrestat was first synthesized in 1969 and was the first aldose reductase inhibitor (ARI) with oral bioavailability to undergo clinical trials, in the late 1970s and early 1980s. Low-quality trials and a high incidence of adverse effects (particularly hepatotoxicity) led to termination of its development, and it was never in clinical use.[3][4] It is structurally related to tolrestat, another ARI that was briefly marketed before being withdrawn in 1997.
^Gabbay KH, Spack N, Loo S, Hirsch HJ, Ackil AA (April 1979). "Aldose reductase inhibition: studies with alrestatin". Metab Clin Exp. 28 (4 Suppl 1): 471–6. doi:10.1016/0026-0495(79)90059-3. PMID122298.
^Ehrig T, Bohren KM, Prendergast FG, Gabbay KH (June 1994). "Mechanism of aldose reductase inhibition: binding of NADP+/NADPH and alrestatin-like inhibitors". Biochemistry. 33 (23): 7157–65. doi:10.1021/bi00189a019. PMID8003482.
^Striker, Gary E.; Gueriguian, John L. (1991). Diabetic complications: epidemiology and pathogenetic mechanisms. New York: Raven Press. pp. 293–4. ISBN0-88167-648-9.