Simeticone Explained

Simeticone (INN), also known as simethicone (USAN), is an anti-foaming agent used to reduce bloating, discomfort or pain caused by excessive gas.

Medical uses

Simeticone is used to relieve the symptoms of excessive gas in the gastrointestinal tract, namely bloating, burping, and flatulence.^{[1] [2]} While there is a lack of conclusive evidence that simeticone is effective for this use,⁣^{[3] [4]} studies have shown that it can relieve symptoms of functional dyspepsia^[5] and functional bloating.^[6]

It has not been fully established that simeticone is useful to treat colic in babies,^[7] and it is not recommended for this purpose.^[4] A study in the United Kingdom reported that according to parental perception simeticone helped infant colic in some cases.^[8]

Simeticone can also be used for suspected postoperative abdominal discomfort in infants.^[9]

Side effects

Simeticone does not have any serious side effects. Two uncommon side effects (occurring in 1 in 100 to 1 in 1,000 patients) are constipation and nausea.^[10]

Pharmacology

Simeticone is a non-systemic surfactant which decreases the surface tension of gas bubbles in the GI tract.^[11] This allows gas bubbles to leave the GI tract as flatulence or belching. Simeticone does not reduce or prevent the formation of gas.^[12] Its effectiveness has been shown in several in vitro studies.^{[13] [14]}

Chemistry

Simeticone is a mixture of dimethicone and silicon dioxide.^[15]

Names

The INN name is "simeticone", which was added to the INN recommended list in 1999.^[16]

Simeticone is marketed under many brand names and in many combination drugs; it is also marketed as a veterinary drug.^[17]

Brand names include A.F., Acid Off, Aero Red, Aero-OM, Aero-Sim, Aerocol, Aerox, Aesim, Aflat, Air-X, Anaflat, Antiflat, Baby Rest, Bicarsim, Bicarsim Forte, Blow-X, Bobotic, Bobotik, Carbogasol, Colic E, Colin, Cuplaton, Degas, Dentinox, Dermatix, Digesta, Dimetikon Meda, Disflatyl, Disolgas, Elugan N, Elzym, Endo-Paractol, Enterosilicona, Espaven Antigas, Espumisan, Espumisan L, Flacol, Flapex, Flatidyl, Flatoril, Flatulex, Flucolic, Gas X, Gas-X, Gaselab, Gaseoflat, Gaseoflatex, Gaseophar, Gaseoplus, Gaseovet, Gaservol, Gasimetin, Gasnil, Gasofilm, Gastrex, Gastrosen, Gazim X, Gazix, Geludrox-HS, Genasyme, Ilio-Funkton, Imogas, Imogaze, Imonogas, Infacalm, Infacol, Infacolic, Lefax, Lefaxin, Lefoam, Logastin, Luftal, Maxi Flat, Meteosim, Metiorisan, Metsil, Mylanta, Mylicon, Mylicongas, Mylom, Mymus, Nanog, Neodrop, Neogasol, Neolanta, Orocure, Ovol, Pedicon, Phazin, Phazyme, Restime, Rugby Gas Relief, Sab Simplex, Salinal, Semecon, Semeth, Sicongast, Siflat, Silbione, Siligas, Silipin, Sim, Simcone, Simecon, Simecrin, Simedill, Simegut, Simet, Simethicon, Simethicone, Simetic, Simeticon, Simeticona, Simeticone, Siméticone, Simeticonum, Simetigast, Simflat, Simicol, Simicon, Wilcon, Wind-eze and WindSetlers.^[17]

It is also marketed as a combination drug:^[17]

• with algeldrate as Kestomatine
• with aluminium or magnesium salts and in some cases both, as Alamag Plus, Almacone, Alposim, Aluphagel, Alutop, Amico-L Andursil, Axcel Eviline, Boots Wind Relief, Di-Gel, Diovol Plus, Diovol Plus AF, Gas Ban DS, Hydrosil, Iosopan Plus, Kremil, Kremil-S, Maalox Plus, Mi-Acid, Mygel, Mylagen, Polysilane Delalande, Rumibex and Trial AG
• with alverine as Avarin, Meteospasmyl, Nady-Spasmyl
• with barium sulfate as Bario Dif
• with bismuth as Gastop
• with calcium carbonate as Flamints, Gaseoflatex Plus, Malugel, Titralac Plus
• with activated charcoal as Carbosylane, Clingest, Finigax. Flatuna
• with cinitapride as Rogastril Plus
• with clebopride as Flatoril
• with dicycloverine as Cloact, Colicspam, Colimix, Colispas, Coliza-D, Cyclopam, Fri-Spas, Meftal Spas, Respas, Simcomine, Spasact, Spasmindon DPS
• with domperidone as Bigetric, Dom Simecon, Doprokin-S, Glomoti, Moperidona AF, Mutecium, Praxis
• with hydrotalcite as Altacide and Talsil Forte
• with homatropine as Aero-Sim Compuesto, Asestor, Factor AG, Sedotropina Flat
• with lactulose as Dinolak
• with levonorgestrel as Jaydess
• with loperamide as Eldoper Plus, Imodium Duo, Imolopesim, Loperamide HCl/Dimeticon, Loperuma, Lositala, Losiwuto, Regulane AF, Stoperan Plus, Toban F Plus
• with magaldrate as Aci Basic, Aci-Tip, Acicone-S, Acid-Farvet, Acifin, Amalset, Antiax, Asidrat, Assis, Avicid, Banacid-s, Buenox, Cremalon, Curecid, Digax, Digeril, Endcid, Gaseovet MS, Gastrine, Gastrogel, Gastroral, Gastrorapid, Magacid, Magal-D, Magalat, Magaldrato+Simeticona, Magaldrax, Maganta Plus, Magsilon, Marlox Plus, Megacil Plus, Megalrat Plus, Minicidez, Miopan Plus, Novelta, Oxecone-MS, Riopan Plus, Rolac Plus, Sedo Mag, Simagal, Simelgat Plus, Taimacon, Zymcon
• with metoclopramide as Anaflat Compuesto, Di-Aero OM, Digespar, Factorine, Pangastren
• with mosapride as M-Pride-MPS, Moxar, Moza MPS
• with pancreatin as Anaflat Enzimático, Digenil, Digesflat, Enzym Lefax, Enzymet, Enzymin, fermento duodenal, Finigax Indigestion, Flaton, Flazymec, Gasflat, Gaszym, Gesdyp, Hazmolin, Komflat, MeteoZym, Pankreoflat, Tripanzym
• with papaverine as Espasmo Siligas
• with pinaverium as Alevian Duo, Pladuet, Planex
• with pipenzolate bromide as Cadinol, Gasorbol Gotas
• with phloroglucinol as Meteoxane
• with trimebutine as Eumotil-S, Eumotrix Plus, Libertrim SDP, Libertrim SII, Muvett S
• with urea as Hidribet.

It is also marketed as a veterinary drug under the brands Birp and Methysilox.

Notes and References

1. Web site: Simethicone tablet. NIH DailyMed. 27 August 2017. April 2016.
2. Web site: Simeticone. NHS. en. 10 October 2019. 30 January 2020.
3. Web site: Modi R, Clearfield HR, Levitt M . Belching, Bloating and Flatulence. American College of Gastroenterology. en. July 2013.
4. Web site: Simethicone . . Efficacy not established for the symptomatic relief of immediate postprandial upper abdominal distress.
5. Holtmann G, Gschossmann J, Mayr P, Talley NJ . A randomized placebo-controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia . Alimentary Pharmacology & Therapeutics . 16 . 9 . 1641–8 . September 2002 . 12197843 . 10.1046/j.1365-2036.2002.01322.x . Wiley . 23286985 .
6. Burta O, Iacobescu C, Mateescu RB, Nicolaie T, Tiuca N, Pop CS . Efficacy and safety of APT036 versus simethicone in the treatment of functional bloating: a multicentre, randomised, double-blind, parallel group, clinical study . Translational Gastroenterology and Hepatology . 3 . 72 . 72 . 25 September 2018 . 30511026 . 6256934 . 10.21037/tgh.2018.09.11 . AME Publications . free .
7. Biagioli E, Tarasco V, Lingua C, Moja L, Savino F . Pain-relieving agents for infantile colic . The Cochrane Database of Systematic Reviews . 2016 . CD009999 . September 2016 . 9 . 27631535 . 6457752 . 10.1002/14651858.CD009999.pub2 .
8. Goldman M, Beaumont T . A real world evaluation of a treatment for infant colic based on the experience and perceptions of 4004 parents . British Journal of Nursing . 26 . 5 Suppl 1 . S3–S10 . March 2017 . 28350192 . 10.12968/bjon.2017.26.Sup5.S3 . 32885530 .
9. Voepel-Lewis TD, Malviya S, Burke C, D'Agostino R, Hadden SM, Siewert M, Tait AR . Evaluation of simethicone for the treatment of postoperative abdominal discomfort in infants . Journal of Clinical Anesthesia . 10 . 2 . 91–94 . March 1998 . 9524891 . 10.1016/S0952-8180(97)00249-3 .
10. Web site: Simethicone Side Effects in Detail . Drugs.com . 27 August 2017.
11. Ingold CJ, Akhondi H . January 2021. Simethicone. StatPearls [Internet].. 32310457 .
12. Web site: Treatment of Gas. International Foundation for Functional Gastrointestinal Disorders. en-gb. 4 September 2015.
13. Brecević L, Bosan-Kilibarda I, Strajnar F . Mechanism of antifoaming action of simethicone . Journal of Applied Toxicology . 14 . 3 . 207–11 . May 1994 . 8083482 . 10.1002/jat.2550140311 . 30 January 2020 . Wiley . 7453218 .
14. Dittrich M, Miederer SE, Havertz B, Krastev R . Schaumzerstörung und Schaumverhinderung: Der Wirkmechanismus von Simeticon in vitro . Journal für Gastroenterologische und Hepatologische Erkrankungen. . Defoaming and antifoaming action of simethicone in vitro . German . 12 May 2010 . 8 . 3 . 19–25 . Krause & Pachernegg .
15. Encyclopedia: O'Neil MJ . The Merck Index . Dimethicone . 14th . 2006 . Merck . Whitehouse Station, NJ . 545 .
16. Recommended INN List 42. WHO Drug Information. 1999. 13. 3. 202.
17. Web site: Simeticone international brands. Drugs.com. 27 August 2017.