Drugs for functional bowel disorders. Antifoaming agents
Código ATC: A03AX13 (Simeticone)
Marcas comerciales
Mylicon, Gas-X, Phazyme
Reduces surface tension of gas bubbles in the GI tract and promotes their coalescence. The freed gas is expelled naturally or absorbed by the mucosa. The drug is not systemically absorbed and acts only locally in the GI lumen. Chemically inert and does not react with other drugs.
Terapia coadyuvante
Simeticone is used as a standard component of preparation for endoscopic (EGD, colonoscopy) and abdominal ultrasound studies. It reduces foam and gas in the lumen, improves mucosal visualization and increases diagnostic accuracy. Dose 80–240 mg 20–30 minutes before the procedure. Meta-analyses confirm improved examination quality in colonoscopy and EGD.
Terapia coadyuvante
In functional bloating, simeticone may reduce symptom severity in short courses. The evidence base is limited to small RCTs; and mention the drug as a symptomatic option without first-line status. Effect is unpredictable: some patients report significant relief, others none.
Course limited to 2–4 weeks. If symptoms persist, reassess the diagnosis and work up for SIBO, lactase deficiency, celiac disease and IBS.
No recomendado
Simeticone is not effective in GERD as standalone therapy – it does not suppress acid production or protect esophageal mucosa. In combination antacids (e.g. Almagel Neo) simeticone is an additive component but does not affect disease outcomes.
No recomendado
Simeticone has not been shown to be effective in infantile colic. Systematic reviews and meta-analyses (NASPGHAN 2017, Cochrane) show no benefit over placebo in RCTs. NASPGHAN 2017 does not recommend routine use. Despite this, simeticone remains one of the best-selling «colic» drugs in Russia and CIS – a marketing effect rather than a clinical one. Parents are informed that colic is a self-limited state that resolves by 4–5 months.
No FDA category assigned. The drug is not absorbed, and fetal risk is minimal. Use during pregnancy is acceptable when needed.
Not absorbed, does not enter milk in active form. Compatible with breastfeeding.
Simeticone is evaluated for the following indications with varying evidence strength: Preparation for endoscopy or ultrasound (evidence tier A), Functional bloating (evidence tier B), Infantile colic (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Simeticone (≥ 1 in 100): Allergic reactions (urticaria, rash). See the Safety section for uncommon and serious reactions.
No FDA category assigned. The drug is not absorbed, and fetal risk is minimal. Use during pregnancy is acceptable when needed.
Not absorbed, does not enter milk in active form. Compatible with breastfeeding.
Simeticone is contraindicated in: Hypersensitivity to simeticone or excipients; Bowel obstruction. Full list in the Safety section.
simeticone acts only in the GI lumen and does not address the causes of gas production (diet, SIBO, dysbiosis, enzymopathies).
prophylactic use is not justified, has no proven benefit and reflects only marketing positioning.
in structural pathology (celiac disease, IBS, tumors) the drug does not target the main mechanism. Symptomatic relief does not replace diagnostic workup.