{
  "schema_version": 1,
  "kind": "condition",
  "id": "flatulence-bloating",
  "name": "Flatulence and bloating",
  "category": "chronic",
  "sources": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph) · Zhang L, Sizar O, Higginbotham K. Meteorism. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; last update October 17, 2022.",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 738,
      "generic": "Simethicone",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "100-200 mg taken 3 or 4 times daily or as required",
      "adult_duration": "As required. If the bloating is still there after 4 weeks, look for a cause rather than repeating the prescription",
      "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (simethicone monograph)",
      "rationale": "The Egyptian formulary lists this exact complaint as the indication - flatulence, wind pains, bloating and abdominal distension. It works physically, by collapsing gas bubbles, and is not absorbed at all. On pregnancy and lactation the formulary's own position is that, being unabsorbed, it is not expected to do harm in either - while adding that caution belongs with any drug in those conditions.",
      "cautions": [
        "This relieves a symptom and treats nothing. New or persistent bloating deserves a diagnosis, not a repeat prescription.",
        "New persistent bloating in a woman over 50 is an ovarian cancer red flag until proved otherwise - examine the abdomen and pelvis, and consider CA125 and pelvic ultrasound.",
        "Weight loss, a change in bowel habit, rectal bleeding, vomiting or a palpable mass alongside the bloating all need investigating, not an antiflatulent.",
        "Look for the common treatable causes first: constipation, lactose intolerance, coeliac disease and irritable bowel syndrome account for most of it.",
        "Activated charcoal is widely sold for wind in Egypt and is deliberately not offered here. The evidence it helps gas is poor, and it adsorbs other medicines taken at the same time - including the oral contraceptive pill.",
        "Most Egyptian simethicone packs are combined with an antacid. Check what is actually in the box before adding it to another antacid."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "The formulary gives one regimen for adults, the elderly and children alike: 100-200 mg 3 or 4 times daily. In infants it is the 40 mg/0.6 mL oral drops that are sold.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "SIMETHICONE 80MG 30 TAB.U.S.P.XXII",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMOUN > PYRAMIDS TRADING",
          "price_egp": 5.75,
          "pack_count": 30,
          "unit_price": 0.19,
          "strength_mg": 80.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "DISFLATYL 40 MG 30 CHEW. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR > VALEANT PHARMA",
          "price_egp": 54.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FLATIDYL 40MG 30 CHEWABLE TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA",
          "price_egp": 54.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "GASIFLATYL 40 MG 30 CHEW. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 54.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BLINCOREST 125 MG 30 CHEW. TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "P & C LABS",
          "price_egp": 69.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 125.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BABY REST 40MG/0.6ML ORAL DROPS 15 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 16.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 40.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SIMETHICONE 2% (30ML) ORAL DROPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMRIYA",
          "price_egp": 24.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "flatulence-bloating"
    }
  ]
}