Dicyclomine and Simethicone Suspension: Uses, Dose, Side Effects (2026)

• Updated 23 October 2026
• Reviewed by Sudhanshu Singhal
• 20 min read
• 28 sources

Prices are as shown by the e-pharmacy Tata 1mg on 23 October 2026 for brands in stock that day; prices change by batch, so the MRP printed on the pack governs.

What is dicyclomine with simethicone, activated dimethicone or mefenamic acid?

These are fixed-dose combinations of the antispasmodic dicyclomine hydrochloride with either an anti-foaming agent or an NSAID painkiller. Each ingredient has its own official label and its own action, and the pack in your hand governs.

Dicyclomine (dicycloverine)

The US label calls dicyclomine "an antispasmodic and anticholinergic (antimuscarinic) agent", with an initial US approval in 1950. In the UK it is classified as ATC A03AA07, "Drugs for functional gastrointestinal disorders; Synthetic anticholinergics, esters with tertiary amino group".

It works through a dual mechanism, according to the US label: an anticholinergic (antimuscarinic) effect with about one-eighth the milligram potency of atropine in vitro, plus a direct effect on smooth muscle (musculotropic), so that it "relieves smooth muscle spasm of the gastrointestinal tract". It is rapidly absorbed, reaching peak blood level within 60 to 90 minutes; the elimination half-life is about 1.8 hours in one study, with 79.5% of a dose leaving the body in urine and 8.4% in faeces.

Simethicone, dimethicone and "activated dimethicone"

Simethicone (UK and Ireland spelling simeticone) is an anti-foaming agent that acts inside the gut and is not absorbed. The Infacol SmPC describes it as "a chemically inert, non-systemic gastric defoaming agent that works by altering the elasticity of interfaces of mucus-embedded bubbles", so that bubbles break down or join together and gas passes more easily by belching or flatus.

Simethicone is described as a mixture of dimethicone and silicon dioxide, and the Gas-X Extra Strength label lists dimethicone and silicon dioxide among its ingredients. Some Indian drops name this ingredient "activated dimethicone"; check the wording on your own pack.

Mefenamic acid

Mefenamic acid is a non-steroidal anti-inflammatory drug (NSAID). The UK SmPC calls it "a non-steroidal anti-inflammatory agent with analgesic properties, and a demonstrable antipyretic effect" that "has been shown to inhibit prostaglandin activity"; the US label says its action "is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2)". Blood level peaks 2 to 4 hours after a dose.

Forms and strengths listed in India

• Suspension: dicyclomine 10 mg + simethicone 40 mg, in 30 ml and 60 ml bottles.
• Drops: dicyclomine 10 mg + simethicone 40 mg (15 ml), and dicyclomine 10 mg + dimethicone 40 mg (10 ml and 15 ml).
• Tablets: dicyclomine 10 mg + mefenamic acid 250 mg, strip of 10.
• Other listings on Tata 1mg: Meftal-Spas DS with dicyclomine 20 mg + mefenamic acid 500 mg, and Mefmin Spas with dicyclomine 10 mg + dimethicone 50 mg + mefenamic acid 250 mg.

India's essential-medicines list, NLEM 2022, carries dicyclomine as tablet 10 mg, oral solution 10 mg/5 mL and injection 10 mg/mL, and mefenamic acid as tablet 250 mg and oral liquid 100 mg/5 mL. Simethicone is not listed in the NLEM 2022 text, and none of these fixed combinations appears there as such.

One practical caution about strength basis: some listings show "10 mg + 40 mg" without a volume, others show the same figures per 5 ml (a suspension) or per 1 ml (drops). A drop concentrate at 10 mg per ml is several times stronger by volume than a 10 mg per 5 ml solution, so the two must never be swapped by volume; the concentration stated on your pack governs.

What is it used for?

Each ingredient has its own approved use on its own label, and no off-label use is described here. Because dicyclomine and mefenamic acid are Schedule H drugs in India and the Indian listings read show these brands as prescription medicines, they must be taken only as prescribed by a doctor.

• Dicyclomine, US label: "indicated for the treatment of patients with functional bowel/irritable bowel syndrome"; the BENTYL label carries the same indication.
• Dicycloverine, UK SmPC: "a smooth muscle antispasmodic primarily indicated for treatment of functional conditions involving smooth muscle spasm of the gastrointestinal tract"; the oral solution SmPC adds that "the commonest of these are irritable colon (mucous colitis, spastic colon)".
• MedlinePlus: dicyclomine "is used to treat the symptoms of irritable bowel syndrome".
• Simethicone, US over-the-counter rules: the labelled purpose is relief of "the symptoms referred to as gas", meaning one or more of bloating, pressure, fullness or a stuffed feeling; the product is called an antiflatulent or antigas.
• Simethicone infant drops, US label: "relieves the discomfort of infant gas frequently caused by air swallowing or certain formulas or foods"; the Infacol SmPC states "an antiflatulent for the relief of griping pain, colic or wind due to swallowed air".
• Mefenamic acid, US label: "management of mild to moderate pain in patient 14 years of age and older, when therapy will not exceed one week (7 days)", and treatment of primary dysmenorrhea.
• Mefenamic acid, UK SmPC: rheumatoid arthritis, osteoarthritis and muscular, traumatic, dental, headache, post-operative and postpartum pain, pyrexia in children, primary dysmenorrhoea, and menorrhagia of dysfunctional cause or related to an IUD.

For the combinations, Indian product listings describe the suspension as "commonly given to treat stomach pain, bloating, and abdominal cramps", and the tablet for menstrual pain and abdominal cramp; your doctor decides what the medicine is for in your case.

Dose as stated in the labels

The dose must always come from your doctor and the pack leaflet in your hand, and what follows is only a description of what named labels state; it is not a dosing instruction. Never change a dose on your own, never share a prescription medicine, and never give one to a child on your own judgement.

Dicyclomine

• US label, usual adult dose stated in the label: 20 mg four times a day to start, which may be raised to 40 mg four times a day after one week unless side effects limit it. The label directs that treatment stop if there is no benefit within 2 weeks or if side effects force the dose below 80 mg a day, and it states that safety data are not documented above 80 mg daily for periods longer than 2 weeks.
• UK tablets: adults and children 12 years and over, one to two 10 mg tablets three times daily before or after meals, or one 20 mg tablet three times daily; children 2 to 12 years, one 10 mg tablet three times daily. The leaflet says to keep taking until the doctor says to stop.
• UK oral solution 10 mg/5 ml: adults one to two 5 ml spoonfuls three times daily; children 2 to 12 years one 5 ml spoonful three times daily; children 6 months to 2 years, 5 to 10 mg three or four times daily 15 minutes before feeds, not above 40 mg a day. These figures belong to that single-ingredient UK product and are not instructions for any Indian combination.
• India: product listings say the prescribed dose is given by mouth before a meal or as the doctor suggests, that the suspension is shaken well and measured with a measuring cup, that drops are measured with a marked dropper, and that the medicine should not be continued beyond 2 weeks without asking the doctor. The pack leaflet governs.

Simethicone

• Infacol 40 mg/ml, infants: 20 mg (0.5 ml) orally before each feed, "if necessary this may be increased to 40mg (1ml)".
• Infants' Mylicon 20 mg/0.3 ml: infants under 2 years (under 24 lb) 0.3 ml, children over 2 (over 24 lb) 0.6 ml, repeated after meals and at bedtime, not more than 12 doses a day, using only the enclosed syringe.
• Gas-X 125 mg chewable, 12 years and older: one or two tablets after meals and at bedtime, not more than 4 tablets in 24 hours unless a doctor advises.
• US over-the-counter rules set a maximum daily dose of simethicone of 500 mg.

Mefenamic acid

• US label, usual dose stated in the label: adults and children 14 years and over, 500 mg once and then 250 mg every 6 hours as needed, for pain not longer than 7 days; for primary dysmenorrhea, 500 mg and then 250 mg every 6 hours from the onset of bleeding. Safety and effectiveness for pain are not established below 14 years of age.
• UK Ponstan SmPC: adults two capsules (500 mg) three times daily, preferably with or after food; children under 12 years are directed to the suspension. The lowest effective dose for the shortest time is advised.
• For the dicyclomine 10 mg + mefenamic acid 250 mg tablet, the dose and minimum age come from the leaflet in your pack and from your doctor.

Side effects

The side effects listed in the labels are mainly anticholinergic ones such as dry mouth, dizziness and blurred vision for dicyclomine, and stomach and gut effects for mefenamic acid; the Infacol SmPC lists no undesirable effects for that simethicone product, while warning that its preservatives "may cause allergic reactions (possible delayed)". Read the lists below with care, and tell your doctor about anything that troubles you.

Common effects

• US dicyclomine label, controlled irritable bowel trials at 40 mg four times a day versus placebo: dizziness 40% against 5%, dry mouth 33% against 5%, blurred vision 27% against 2%, nausea 14% against 6%, somnolence 9% against 1%, asthenia 7% against 1% and nervousness 6% against 2%. Side effects were reported by 61% of patients, and 9% stopped the medicine because of them (2% on placebo).
• UK SmPC frequency table at the usual tablet dose: uncommon (1 in 1,000 to under 1 in 100) dry mouth, thirst and dizziness; rare (1 in 10,000 to under 1 in 1,000) blurred vision, constipation, nausea, vomiting, fatigue, anorexia, headache, sedation, dysuria and rash. The SmPC notes that "undesirable effects seldom occur".
• Simethicone: the Infacol SmPC lists no undesirable effects for that product; the methyl and propyl hydroxybenzoates it contains "may cause allergic reactions (possible delayed)".
• Mefenamic acid, US label: the most frequent reactions, in about 1 to 10% of patients, include abdominal pain, constipation, diarrhoea, dyspepsia, flatulence, heartburn, nausea, vomiting, gastrointestinal ulcers, dizziness, headache, oedema, raised liver enzymes, rashes and tinnitus.

Serious effects described in the labels

• Anticholinergic effects: heat prostration (fever and heat stroke from decreased sweating) in high environmental temperature; confusion, hallucinations, delirium and psychosis, which "usually resolve within 12 to 24 hours after discontinuation"; drowsiness, dizziness and blurred vision.
• Bowel effects: diarrhoea may be an early symptom of incomplete intestinal obstruction, and large doses in ulcerative colitis may cause paralytic ileus or toxic megacolon.
• Reports after marketing: palpitations, tachyarrhythmias, angioedema, anaphylactic shock, syncope, delirium and suppressed lactation.
• Infants: published cases report that dicyclomine given to infants was followed by serious respiratory symptoms, seizures, syncope, pulse-rate changes, muscular hypotonia, coma and death, although "no causal relationship has been established".
• Mefenamic acid carries a boxed warning on serious cardiovascular and gastrointestinal events including bleeding, ulceration and perforation, which can be fatal; serious skin reactions including DRESS and Stevens-Johnson syndrome are described, and the label directs that the medicine be stopped at the first rash or sign of hypersensitivity. The UK SmPC adds that if diarrhoea develops on mefenamic acid, the drug should be withdrawn immediately and not given again.

The US label warns that drowsiness, dizziness and blurred vision can affect your ability to drive or operate machinery, and tells patients not to drive when affected. Ask your doctor what to do about work and travel while you are on any of these medicines.

Who should not take it, and interactions

Every ingredient has its own contraindications and warnings, and the tablet combination carries both the anticholinergic list and the NSAID list together, so tell your doctor about every medicine and condition before starting.

Contraindications and cautions

• Dicyclomine, US label contraindications: infants under 6 months, nursing mothers, unstable cardiovascular status in acute hemorrhage, myasthenia gravis, glaucoma, obstructive uropathy, obstructive disease of the gastrointestinal tract, severe ulcerative colitis and reflux esophagitis.
• Dicycloverine, UK tablet SmPC: the contraindication list is narrower (hypersensitivity and known idiosyncrasy), while glaucoma, prostatic hypertrophy and hiatus hernia with reflux oesophagitis are "use with caution" warnings; the UK oral solution SmPC is contraindicated in children under 6 months.
• Caution groups in the US label: prostatic enlargement, hepatic or renal impairment, the elderly, autonomic neuropathy, fever and Salmonella dysentery. MedlinePlus advises that "older adults should not usually take dicyclomine".
• Mefenamic acid, US label: not for anyone with hypersensitivity, a history of asthma, urticaria or allergic reaction after aspirin or other NSAIDs, or around coronary artery bypass surgery. The UK SmPC adds inflammatory bowel disease, previous gastrointestinal bleeding or perforation from NSAIDs, active or recurrent peptic ulcer, severe heart, liver or kidney failure, and the last trimester of pregnancy.
• Simethicone: the Infacol SmPC states no contraindications, but notes that levothyroxine "may bind to simeticone", so absorption may be impaired in infants treated for thyroid disorders.

Pregnancy, breastfeeding and alcohol

• Pregnancy: the US and UK dicycloverine labels say to use only if clearly needed, noting no increased malformation risk at doses up to 40 mg a day in the first trimester. For mefenamic acid, the US label warns that from about 20 weeks of pregnancy NSAIDs may cause fetal kidney problems and low amniotic fluid, and the UK SmPC contraindicates it in the last trimester.
• Breastfeeding: the US label contraindicates dicyclomine in women who are breastfeeding because it is excreted in human milk, while the UK SmPC says it is not known whether dicycloverine is secreted in human milk and advises caution. Advice differs by label, so follow the leaflet in your pack and ask your doctor; the UK SmPC states that "mefenamic acid should not be taken by nursing mothers".
• Alcohol: MedlinePlus warns that alcohol "can add to the drowsiness caused by this medication", and that warning applies to dicyclomine in any form. For the tablet with mefenamic acid there is an additional warning: the UK SmPC states that drinking alcohol "may increase gastrointestinal bleeding, ulceration and perforation".

Interactions

• Dicyclomine may add to the effects of other anticholinergic-type medicines (amantadine, quinidine, antihistamines, phenothiazines, benzodiazepines, MAO inhibitors, narcotic analgesics, nitrates and tricyclic antidepressants), may oppose metoclopramide, and may raise digoxin levels with slowly dissolving digoxin. Antacids "should be avoided" at the same time as they may interfere with absorption. The UK dicycloverine SmPC states that "no interaction studies have been performed".
• Mefenamic acid: warfarin and other anticoagulants, aspirin and SSRI or SNRI antidepressants raise the bleeding risk; lithium levels can rise; ACE inhibitors and diuretics may work less well.

Rules in India

In India dicyclomine hydrochloride and mefenamic acid are Schedule H prescription drugs under the Drugs and Cosmetics Rules, 1945, and both molecules appear in NLEM 2022 as single-ingredient entries.

• The Drugs and Cosmetics Rules, 1945 (as amended up to 30 September 2020) list "Dicyclomin hydrochloride" at item 150 and "Mefenamic acid" at item 302 of Schedule H. Simethicone and dimethicone are not named in Schedule H or G in that text.
• NLEM 2022, published in the Gazette of India Extraordinary on 11 November 2022, lists dicyclomine at item 17.4.1 (tablet 10 mg, oral solution 10 mg/5 mL, injection 10 mg/mL) and mefenamic acid at item 2.1.4 (tablet 250 mg, oral liquid 100 mg/5 mL). These are single-ingredient entries; none of the fixed combinations in this guide is listed as such, and simethicone does not appear in the list.
• Ceiling prices under the Drugs (Prices Control) Order, 2013 apply to the scheduled single-ingredient formulations; the fixed combinations in this guide are not NLEM-listed.

Top brands in India

The suspension, drops and tablet forms of these combinations are sold in India under many brand names from several companies, and the table near the top of this page lists examples as shown by the e-pharmacy Tata 1mg on 23 October 2026. These are examples in stock on that date and not a ranking, since no published sales-rank source was found; 1mg itself states that MRP may vary by batch, so the price printed on the pack always governs.

Tata 1mg lists all of these brands as prescription medicines.

The Vibcare range

Vibcare Pharma sells six products in three compositions: Vibospas S Suspension (dicyclomine 10 mg + simethicone 40 mg, 60 ml) and Vibospas S Drops (dicyclomine 10 mg + activated dimethicone 40 mg, 15 ml) from the Prima division, and Egaspas (Evermed), Fenaspas (Medanor), Spasjem (Auspin) and Vibospas (Prima) tablets (dicyclomine 10 mg + mefenamic acid 250 mg, 10x10 blister packs) from the Prima, Evermed, Medanor and Auspin divisions. Use them only as prescribed by a doctor and as stated on the pack.

The range is available to Vibcare PCD franchise partners with monopoly rights in their district; see our Gastro PCD franchise and PCD pharma franchise pages.

Frequently asked questions

Sources

Related reading

• About Vibcare Pharma Pvt Ltd
• Manufacturing at Vibcare: WHO-GMP facilities
• PCD pharma franchise with Vibcare