Simethicone Dosing for Bloating
For bloating, use simethicone at a dose of at least 320 mg to achieve clinically meaningful symptom relief, based on the strongest evidence from colonoscopy and gastrointestinal disorder studies. 1, 2
Recommended Dosing Strategy
Standard Dosing for Bloating
- Minimum effective dose: 320 mg for documented efficacy in reducing gas-related symptoms 1, 2
- The FDA-approved over-the-counter formulation contains 180 mg per softgel, with dosing of 1-2 softgels as needed after meals and at bedtime 3
- Do not exceed 2 softgels (360 mg) in 24 hours unless under physician supervision 3
Clinical Context and Evidence Quality
High-quality evidence from colonoscopy studies demonstrates that simethicone doses ≥320 mg significantly reduce bubble formation and improve outcomes, with meta-analysis of 38 trials (10,505 patients) supporting this threshold 1. While these studies focused on colonoscopy preparation, the mechanism of action—reducing gas bubbles in the digestive tract—directly applies to bloating symptoms 2.
For irritable bowel syndrome (IBS) with bloating, combination products containing simethicone have shown efficacy:
- Alverine/simethicone combination produced significant global improvement in IBS symptoms 4
- Pinaverium/simethicone combination specifically improved bloating 4
- Chitin-glucan combined with simethicone (0.75 mg/day divided into three doses) reduced bloating scores from 8.0 to 4.7 (p<0.0001) with 60% responder rate 5
In acute diarrhea with gas-related discomfort, simethicone 125 mg combined with loperamide provided faster relief of gas pain, cramps, pressure, and bloating compared to either component alone 6.
Practical Dosing Algorithm
- Start with 180-360 mg after meals and at bedtime as needed for bloating 3
- Use at least 320 mg for optimal efficacy based on the strongest evidence 1, 2
- Administer after meals when gas-related symptoms are most likely to occur 3
- Maximum daily dose: 360 mg (2 softgels) without physician supervision 3
Important Caveats
Simethicone works locally and is not systemically absorbed—it consolidates gas bubbles to facilitate elimination rather than preventing gas formation 2. This means it addresses symptoms but not underlying causes.
For severe or persistent bloating, simethicone alone may be insufficient and should be part of a comprehensive treatment approach 2. The British Society of Gastroenterology guidelines recommend second-line agents like linaclotide (290 μg once daily) or lubiprostone (8 μg twice daily) for IBS-related bloating when first-line treatments fail 7.
Tolerability is excellent—no significant adverse events were reported in clinical trials, with 93% of patients rating tolerability as "good" or "very good" 5. Simethicone does not increase nausea, vomiting, or abdominal pain compared to placebo 8.
Onset of action: Symptom improvement typically occurs within 2 weeks of regular use 5, though individual doses may provide more immediate relief for acute gas-related discomfort 6.