Antispasmodic with Antifoaming Agent (Fixed-Dose Combination) Pregnancy: Pregnancy and lactation are listed as contraindications in SPC section 4.3; section 4.6 states that as a precautionary measure it is preferable to avoid use during pregnancy, and that the product should be avoided during breastfeeding (it is unknown whether alverine citrate or simeticone are excreted in human milk). No data on effects on human fertility.

Alverine Citrate with Simeticone

Brand names: Audmonal

This is a fixed-dose combination of alverine citrate, an antispasmodic, with simeticone, an antifoaming agent, used for symptomatic relief of irritable bowel syndrome, particularly abdominal pain and bloating.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Adults (including the elderly): 1 soft capsule two to three times daily at the beginning of meals. The SPC fetched is for SimAlvia 60 mg/300 mg soft capsules (alverine citrate 60 mg with simeticone 300 mg per capsule).

Route: Oral

Frequency: Two to three times daily, at the beginning of meals

Max: Up to three times daily (upper end of the SPC dose range; no separate maximum daily dose is stated)

Other causes of gastrointestinal pathology should be ruled out, and patients not improving after 2 weeks of treatment should be reviewed by a physician. Liver function: elevations in ALT and AST greater than twice the upper limit of normal have been reported, sometimes with raised total bilirubin; discontinue if aminotransferases rise above 3 times the upper limit of normal and/or jaundice occurs, and evaluate hepatic function immediately if the patient reports unexplained persistent nausea, decreased appetite, fatigue, vomiting, right upper abdominal pain, jaundice, dark urine or pale faeces. PAEDIATRIC: safety and efficacy in children under 18 years of age have not been established - verify any paediatric use against a children's formulary.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Paralytic ileus
Intestinal obstruction
Use in pregnancy and lactation
History of allergic reaction or intolerance to alverine or to any of the excipients
Hypersensitivity to peanut or soya

Side effects

Cytolytic hepatitis (very rare); elevated transaminases, alkaline phosphatase and bilirubin (frequency not known)
Anaphylactic type reactions and anaphylactic shock (very rare)
Angioedema, skin rash, urticaria and pruritus (frequency not known)
Headache (frequency not known)
Vertigo (frequency not known)
Nausea (frequency not known)

Interactions

None known (SPC section 4.5: 'None known')

Clinical monograph

How it works

Alverine acts directly on intestinal smooth muscle to relieve spasm, while simeticone lowers the surface tension of gas bubbles in the gut to reduce trapped wind and bloating.

Prescribing in practice

It should not be used where paralytic ileus or intestinal obstruction is suspected, as relieving smooth-muscle tone could be harmful in these situations.
Reassess any patient whose abdominal symptoms change in character or who develops alarm features, since IBS remains a diagnosis of exclusion.
It is intended for functional symptom relief and is generally well tolerated, but discontinue if hypersensitivity occurs.

Monitoring

No specific laboratory monitoring is required; review symptom control and reconsider the diagnosis if symptoms persist or escalate.

Counselling the patient

Take to relieve cramping abdominal pain and bloating associated with IBS.
Seek review if you notice bleeding, weight loss, or a persistent change in bowel habit.
Stop and seek advice if you develop a rash or other allergic reaction.

Evidence & guidelines

NICE guidance on irritable bowel syndrome supports antispasmodics for abdominal pain and spasm, alongside dietary and lifestyle measures.

Reference: NICE CKS IBS (2023); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways