Simeticone

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

Medical uses

Simethicone is used to relieve the symptoms of excessive gas in the gastrointestinal tract, namely bloating, burping, and flatulence. While there is a lack of conclusive evidence that simethicone is effective for this use,⁣ studies have shown that it can relieve symptoms of functional dyspepsia and functional bloating.
It has not been fully established that simethicone is useful to treat colic in babies, and it is not recommended for this purpose. A study in the United Kingdom reported that according to parental perception simethicone helped infant colic in some cases.
Simethicone can also be used for suspected postoperative abdominal discomfort in infants.

Side effects

Simethicone does not have any serious side effects. Two uncommon side effects are constipation and nausea.
Though poorly documented, some studies show a possible negative interaction between simethicone and levothyroxine, meaning it can possibly bind levothyroxine in the GI tract and hence reduce its absorption leaving the patient prone to clinical manifestations of hypothyroidism. It is important to mention the long T_1/2 of levothyroxine which makes the phenomenon a matter of at least a week of using levothyroxine with simethicone. To prevent this interaction, simethicone is recommended to be taken at least 4 hours before or after levothyroxine.

Pharmacology

Simethicone is a non-systemic surfactant which decreases the surface tension of gas bubbles in the GI tract. This allows gas bubbles to leave the GI tract as flatulence or belching. Simethicone does not reduce or prevent the formation of gas. Its effectiveness has been shown in several in vitro studies.

Chemistry

Simethicone is a mixture of dimethicone and silicon dioxide.

Names

The INN name is "simethicone", which was added to the INN recommended list in 1999.
Simethicone is marketed under many brand names and in many combination drugs; it is also marketed as a veterinary drug.
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, Polysilane Junior, 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.
It is also marketed as a combination drug:

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, Magasida, Mi-Acid, Mygel, Mylagen, Mylanta, Polysilane, 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.