alverine citrate + simeticone: clinical use

Prescribing considerations

• Licensed only for adult IBS-related abdominal pain.
• Exclude other gastrointestinal pathology, particularly when symptoms are new, worsening or persistent.
• Assess promptly for hepatic injury if compatible symptoms develop; discontinue if aminotransferases exceed three times the upper limit of normal and/or jaundice occurs.
• Vertigo may impair driving or machinery use.

Contraindications and cautions

• Paralytic ileus.
• Intestinal obstruction.
• Pregnancy or breastfeeding.
• Previous allergy or intolerance to alverine, simeticone or an excipient.
• Peanut or soya hypersensitivity because the capsule contains soya lecithin.

Monitoring

• Routine laboratory monitoring is not specified.
• Check liver function promptly if jaundice, dark urine, pale stools, persistent nausea or vomiting, anorexia, fatigue or right-upper-quadrant pain develops.
• Reassess the diagnosis if symptoms worsen or fail to improve after two weeks.

Clinical pharmacology

Alverine is a non-atropinic, papaverine-like musculotropic antispasmodic. Simeticone acts physically by reducing gas-bubble surface tension, is not absorbed from the gastrointestinal tract and is eliminated unchanged in faeces.

Formulation and product differences

• The selected product is a shiny, opaque-white, oblong soft capsule containing a suspension.
• It contains traces of soya lecithin; the shell and manufacturing components include gelatin, glycerol, titanium dioxide and fractionated coconut oil.
• Its combination-specific indication and contraindications should not be extrapolated from alverine-only products.