Flatoril

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Flatoril

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Flatoril

Quick Facts

Property Description
Active Ingredients Clebopride, Simethicone
Form Hard capsules, Oral solution
Pharmacological Class Gastrointestinal Agent (Propulsive and Antiflatulent)
Common General Purpose Relief of symptoms associated with impaired gut movement and gas/bloating
Origin Synthetic

What is Flatoril? Defining the Combination Gastrointestinal Agent

Flatoril is a prescription-only, fixed-dose combination drug administered via the oral route, falling under the broad classification of a Gastrointestinal Agent. Its identity is established by its dual structure, which simultaneously targets both the motility issues and the gas accumulation common in functional digestive disorders. The standard classification of its constituent actions includes a propulsive agent (Clebopride) and an antiflatulent (Simethicone).

Active Ingredients and Product Form

The two active ingredients are Clebopride and Simethicone. Clebopride is a synthetic substituted benzamide and is classified as a propulsive agent for its action on gastrointestinal motility. Simethicone is an inert, synthetic, silicone-based polymer that functions solely as an antiflatulent. This formulation is differentiated by its ability to deliver the systemic action of the prokinetic alongside the purely local action of the defoaming agent, available in hard capsules and as an oral solution.

General Therapeutic Purpose and Rationale

The combination structure provides a dual-action therapeutic effect and dictates the general purpose of the drug. The propulsive agent primarily serves to restore and coordinate the natural, forward movement (motility) of the stomach and intestines. This is often used in scenarios where a patient experiences symptoms like feeling overly full shortly after eating.

The antiflatulent Simethicone then complements this by physically reducing the surface tension of trapped gas bubbles, facilitating their elimination. This strategic dual approach provides relief for general digestive symptoms rooted in both sluggish transit and excessive bloating or flatulence.

What side effects are possible with Flatoril?

Possible side effects and safety information

The safety profile of Flatoril is predominantly associated with the systemic effects of its propulsive agent, Clebopride, as the antiflatulent component, Simethicone, is not systemically absorbed. Regulatory documents classify documented adverse reactions by frequency and affected physiological system.

Adverse effects are documented as falling into either Rare or Very Rare classifications.

Documented Adverse Reactions

System-Organ Class Rare Effects Very Rare Effects
Nervous System Disorders Extrapyramidal disorders (e.g., dystonia, dyskinesia), Sedation, Somnolence, Tremor N/A
Reproductive System & Breast Disorders N/A Galactorrhoea, Gynaecomastia, Amenorrhea, Erectile dysfunction (all linked to hyperprolactinaemia)

Serious Safety Considerations

The most clinically significant documented reactions are Extrapyramidal disorders, which represent involuntary movements. Tardive dyskinesia, a potentially persistent form of these disorders, has been specifically reported in older adults during long-term treatments.

All hyperprolactinaemia-related effects, including galactorrhoea and erectile dysfunction, are likewise associated with long-term exposure.

Safety Restrictions and Special Populations

Due to the potential for rare CNS effects such as sedation, official labeling advises against engaging in activities that require a high state of alertness, such as driving or operating dangerous machinery. Caution is advised for use in patients with severe hepatic failure or severe renal failure, as the drug’s concentration in the body may be increased or prolonged in these populations. The medication is also restricted in conditions where stimulating gastrointestinal motility could be harmful, such as in cases of perforation or mechanical obstruction.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory documents define the overdose profile for Flatoril based on manifestations affecting the central nervous system and motor control, resulting from exposure to quantities beyond the recommended dosage.

Documented Overdose Manifestations

System Affected Clinical Presentation (as stated in label)
Central Nervous System Somnolence (drowsiness), Disorientation
Motor Control Extrapyramidal disorders

Required Emergency Actions and Management

Overdosage is stated to cause these clinical presentations, which normally disappear upon the suspension of the drug treatment. The primary action mandated by regulatory documents is the immediate cessation of the drug. Urgent medical attention is explicitly required if the documented overdose manifestations persist after the treatment is suspended.

If symptoms persist, procedural medical measures must be administered. These officially documented supportive interventions include performing a stomach lavage and providing generalized symptomatic medication. Furthermore, the regulatory text specifies that extrapyramidal disorders are controlled with the administration of specific pharmacological agents, such as antiparkinsonian medication, anticholinergic agents, or antihistaminic agents with anticholinergic properties. The official regulatory profile emphasizes that the persistent presence of symptoms requires professional medical intervention and procedural management exactly as described in the official labeling.

Therapeutic Uses of Flatoril

What Flatoril Treats: Main Uses and Benefits

Flatoril is a medication used in situations involving certain distressing symptoms to provide symptomatic relief by managing disruptive manifestations in the digestive system. It is generally relevant when supportive symptom management is appropriate and is applied across domains where additional symptomatic support is needed, helping to ease disruptive manifestations in contexts marked by increased discomfort or tension. Its main therapeutic areas center around functional gastrointestinal disorders.

Targeting Symptom Clusters

The medication is commonly used to help address symptom clusters that may become intense or disruptive, such as abdominal distension, painful pressure, flatulence, and nausea. This provides support that helps ease the overall symptom burden, and offers symptomatic relief that helps patients cope more steadily with difficult episodes. It is also applied in clinical settings that involve acute or unstable symptom patterns, including before certain diagnostic procedures or for managing temporary discomfort after medical interventions.


Quick Fact: Relief for Symptoms that Interfere with Daily Comfort Flatoril assists with managing symptoms related to functional disorders where significant discomfort arises from gas and motility issues, which may contribute to improved day-to-day comfort during symptomatic periods.

Eligibility and Restrictions for Use

Who Can and Cannot Use Flatoril?

Regulatory documents define eligibility for Flatoril (clebopride/simethicone) based strictly on patient history and specific clinical states. The medicine is contraindicated and must not be used in several defined populations where the risks are deemed unacceptable.


Populations Who Must Not Use Flatoril (Contraindications)

The medicine is absolutely forbidden for individuals with a known hypersensitivity to any of its components. It must also not be used if stimulating the digestive tract's movement (motility) could cause physical harm, such as in cases of gastrointestinal hemorrhage, obstruction, or perforation.

Furthermore, due to the action of clebopride, Flatoril is contraindicated in patients with specific neurological conditions, including epilepsy, Parkinson's disease, or other extrapyramidal disorders, or a confirmed history of neuroleptic-induced tardive dyskinesia.

Populations Requiring Special Consideration

Use of Flatoril is restricted or requires caution for certain groups. The medicine should preferably be avoided during both pregnancy and lactation as a precautionary measure due to limited safety data. Elderly patients and those with severe hepatic (liver) or renal (kidney) failure must use the medicine with caution, as these factors can increase the concentration of the drug in the body and potentially heighten the risk of adverse reactions.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The interaction profile for Flatoril is determined by the actions of Clebopride, as its co-formulated component, Simethicone, is classified by regulators as pharmacologically inert regarding systemic drug interactions.


Pharmacodynamic Effects and Restrictions

Regulatory documentation notes that co-administration with central nervous system (CNS) depressants results in enhanced sedative effects. This documented interaction applies to substances like alcohol, anxiolytics, hypnotic agents, and narcotics. The effects of phenothiazines and other antidopaminergic agents on the CNS are also enhanced. Conversely, anticholinergic agents and narcotic analgesics can neutralise the propulsive effect of clebopride in the gastrointestinal tract.

Furthermore, the combination of clebopride with Monoamine Oxidase Inhibitors (IMAO) is formally noted to potentially increase the risk of adverse reactions. The overall profile includes a restriction against use when stimulation of gastrointestinal motility, such as in cases of haemorrhage, obstruction, or perforation, could be harmful.


Alteration of Drug Exposure

Due to the drug's mechanism of increasing gastrointestinal motility, it can alter the pharmacokinetics of any concomitantly administered medicine. This effect is specifically documented as reducing the therapeutic effects of both digoxin and cimetidine due to reduced absorption.

Mechanism of Action

How Flatoril Works

Dopamine Receptor Modulation and Motility Enhancement

This mechanism involves the chemical action of one component on peripheral D2-dopamine receptors located in the digestive tract. The antagonism of these receptors disinhibits the local release of acetylcholine, a key neurotransmitter in the enteric nervous system. This molecular cascade enhances the force and coordination of peristalsis (rhythmic muscle contractions), operating within core gastrointestinal neuroregulation pathways to increase the transit velocity of contents and gas.

Physical Anti-foaming for Gas Clearance

The second component exerts a physical action directly within the gut lumen by modifying the surface tension of liquid surrounding small gas bubbles. This targeted physical interference causes the numerous small bubbles to coalesce into larger, more easily mobilized gas aggregates. This action contributes to the mechanical clearance of gas from the digestive system.

Dual-Action Combined Mechanism

The overall physiological effect arises from the combined action of these two distinct mechanisms. The enhanced motility (chemical action) facilitates propulsion, while the physical transformation of gas (anti-foaming action) ensures the gas is in an expellable form. This coordinated, dual mechanism modulates the processes driving content and gas clearance.

Dosage and Administration Information

Flatoril, a fixed-dose combination containing Clebopride and Simethicone, is strictly administered via the oral route. It is commercially available as hard capsules and an oral solution. The hard capsule formulation contains 0.5 mg of Clebopride and 200 mg of Simethicone per unit.

The dosing regimen is determined by the required clinical context. For routine symptomatic administration, the standard adult schedule is one capsule taken three times a day (TID). It is an explicit instruction that this dose must be ingested before each meal to align with the medicine’s time-related usage patterns.

A distinct administration schedule applies when the drug is used for preparation prior to certain diagnostic procedures. In this scenario, the guidance specifies the use of a single capsule administered 2 hours before the scheduled radiological test.

Regarding high-level administration for specific patient groups, the label indicates that a reduction in the dose may be advisable in certain cases. Further, the medicine should be used with caution in patients with severe hepatic or renal failure. This population-specific instruction is based on prescribing standards for drugs with potential accumulation concerns.

Recent Clinical Evidence

Research Exploring Functional Digestive Symptoms

Research has examined Flatoril, a combination of a propulsive agent and an antiflatulent, for research exploring how symptoms change over time, such as abdominal distension, flatulence, and general discomfort associated with conditions characterized by fluctuating or episodic manifestations of digestive discomfort. The research mainly consists of short-term Randomized Controlled Trials (RCTs) and comparative studies that were applied in studies examining patient-reported experiences in Adults with these specific functional issues.

Studies monitored patient-reported outcomes describing perceived discomfort related to abdominal distension, flatulence, and general feelings of fullness or nausea. Research explored whether the use of the medication was associated with changes measured during the study period in global symptom scores. The available research provides insight into short-term changes over defined time intervals. However, the evidence contributing to the broader evidence landscape is sometimes synthesized from trials focusing on the individual active components. Because of this, the evidence quality may be considered Moderate, and certainty remains low regarding long-term effects.


Research Exploring Use in Diagnostic Procedures

Flatoril was evaluated in research for its use as a preparation aid before certain diagnostic procedures. These studies, including RCTs, were conducted during periods of increased symptom activity or before procedures like ultrasound (echography) or endoscopy. The focus of the research was on the antiflatulent component, Simethicone.

The study outcomes examined in this context included objective scores for the quality of visualization of internal organs during imaging. Research describes patterns observed in the studies related to the reduction of gastric distension, which was associated with patterns of clearer image quality in the studies. The evidence for this specific application is considered High (for the antiflatulent component as an adjunct), and studies monitored the antiflatulent component's role in preparation protocols.


Research Exploring Post-Surgery Symptom Patterns

The evidence base, including observational studies and case series, was studied for use in research exploring acute symptom patterns, such as nausea, vomiting, and flatulence, experienced in the immediate post-operative recovery phase. The research base was observed in observational settings evaluating daily-life functioning in post-operative Adults. However, the research base for this specific use is often characterized by modest sample sizes and relies heavily on smaller or non-randomized designs. For this reason, the evidence level may be considered Low.


Gaps and Areas of Uncertainty in the Research

A key limitation noted in the research landscape is that the regulatory position often synthesizes the evidence for the propulsive component and the antiflatulent component separately. There is a need for more comprehensive Randomized Controlled Trials (RCTs) that focus on the fixed-dose combination against placebo or other active treatments for functional digestive disorders. Evidence quality varies across studies, and the reliance on older clinical trial designs means that the overall certainty remains low for certain aspects of the medication's use. Limited information is available for long-term outcomes, and specific data concerning Flatoril's role in long-term symptom management is an area where evidence is limited.

Key Studies & References

  1. New Developments in Prokinetic Therapy for Gastric Motility Disorders (Reviewing Clebopride in Dyspepsia)
  2. Simethicone - StatPearls (Review of use for flatulence and diagnostic imaging)

Frequently Asked Questions (FAQ)

Common questions about Flatoril (FAQ)

Q: How quickly does Flatoril usually start working?

A: Official documents do not provide a specific time-to-onset for symptomatic relief. The official label indicates the medicine is taken before each meal to align with its time-related usage patterns.

Q: How long can a person typically take Flatoril?

A: Regulatory documents associate certain neurological and hormonal effects with long-term exposure. The official label does not specify a universal maximum treatment duration, but precautions regarding prolonged use are noted, especially for older adults.

Q: Is Flatoril appropriate for use during pregnancy?

A: Official regulatory guidance states that avoidance of the medicine is advised during pregnancy. This is specified as a precautionary measure due to limited specific safety data available for this population.

Q: Can Flatoril be crushed or split?

A: The official administration text only describes the use of the medicine as intact hard capsules or the oral solution. No regulatory instruction is provided regarding crushing or splitting the capsule formulation.

Q: Can older adults use Flatoril?

A: Regulatory documents advise that elderly patients must use the medicine with caution. This is due to an increased risk of specific neurological disorders, such as Tardive dyskinesia (involuntary movements), during long-term treatment.

Q: Is Flatoril used for conditions other than what's on the label?

A: Official regulatory documents only describe the use of Flatoril for symptoms associated with impaired gut movement and gas/bloating, as defined in its approved indications.

Q: Do you need a prescription for Flatoril?

A: Official documents define Flatoril as a prescription-only, fixed-dose combination drug.

Q: Is Flatoril the same as [common competitor/OTC drug name]?

A: Flatoril is a fixed-dose combination containing two active ingredients, Clebopride and Simethicone. Its identity is established by this specific dual-action structure, which is classified as both a propulsive agent and an antiflatulent.

Q: What kind of relief should I expect from Flatoril?

A: The drug's dual-action mechanism is intended to provide symptomatic relief for digestive issues. This action addresses discomfort rooted in sluggish movement (transit) and excessive gas, such as bloating and flatulence.

Q: Does Flatoril cause weight gain?

A: According to the official safety profile, weight gain is not listed as a documented adverse reaction in the Rare or Very Rare classifications.

Q: Can Flatoril affect your sleep?

A: Official documents list side effects related to altered consciousness, such as Sedation and Somnolence (drowsiness), as rare nervous system disorders. These effects are reported in connection with altered wakefulness and alertness.

Q: Can I take Flatoril if I am already taking herbal supplements?

A: Regulatory documentation notes a risk of enhanced sedative effects when the medicine is co-administered with other CNS depressants. Regulatory documents advise that any concurrent medicines or supplements require consideration due to potential interaction risks.

Q: Is Flatoril safe to take if you have liver issues?

A: Regulatory documents state that the medicine is used with caution in patients with severe hepatic (liver) failure. This is specified because liver issues may increase the drug's concentration in the body.

Q: Is Flatoril safe to take if you have kidney issues?

A: According to official documents, the medicine is used with caution in patients with severe renal (kidney) failure. This is specified because kidney issues may increase the drug's concentration in the body.

Q: Are there any long-term effects associated with Flatoril?

A: The available research landscape notes that evidence is limited for long-term outcomes, and overall certainty remains low for certain aspects of long-term symptom management. Specific serious neurological and hormonal effects are also associated with prolonged exposure.

Q: Does Flatoril contain any substances that are habit-forming?

A: Regulatory documents do not describe Flatoril as containing any substances classified as controlled or habit-forming.

Q: What should I do if I miss a dose of Flatoril?

A: Standard patient guidance describes continuing with the regular schedule if the next dose time is near. Otherwise, the missed dose is only taken if appropriate according to the specific patient's regimen.

Q: What is the difference between Flatoril and a similar-sounding medicine?

A: Flatoril is the specific trade name for the fixed-dose combination of Clebopride and Simethicone. Any similar-sounding medicine may contain different active ingredients, concentrations, or formulations.

Q: How does the drug stay in your system after you stop taking it?

A: The official labeling describes the process of how the drug is cleared from the body, which is managed through standard elimination pathways. The time required for clearance depends on the drug’s pharmacological profile and elimination pathways.

Q: Why does Flatoril need to be taken consistently?

A: The administration schedule is designed to align the medicine's delivery with its time-related usage patterns in the digestive system. Official instructions indicate that the dose is taken before each meal.

Q: Are there different strengths or formulations of Flatoril?

A: Flatoril is officially available in two forms: hard capsules and an oral solution. The hard capsule strength contains 0.5 mg of Clebopride and 200 mg of Simethicone.

Q: Does Flatoril affect blood pressure?

A: Changes in blood pressure (like hypertension or hypotension) are not listed as documented adverse reactions in the Rare or Very Rare classifications in the official safety profile.

Q: What should I know about Flatoril before a surgery?

A: Regulatory documents restrict the use of the medicine where stimulating gastrointestinal motility could be harmful, such as in cases of obstruction or perforation. This is a factor for consideration where stimulating motility could potentially be harmful, which may apply before or after certain surgical procedures.

Q: Does Flatoril interact with birth control pills?

A: Regulatory documents note that the drug can alter the absorption of other concomitantly administered medicines due to increased gastrointestinal motility. This is a mechanism that may affect certain oral contraceptives.

Q: Has Flatoril been recalled or had any major safety warnings?

A: Regulatory authorities maintain records of all safety warnings and actions. The most clinically significant warnings noted on the label concern Extrapyramidal disorders and the risk of Tardive dyskinesia in older adults on long-term treatment.

Q: Does Flatoril affect the heart?

A: Adverse reactions affecting the heart (such as arrhythmias) are not listed as documented effects in the Rare or Very Rare classifications within the official safety profile.

Q: Can Flatoril be taken on an empty stomach?

A: The official administration instructions indicate that the dose is taken before each meal to align the medicine's activity with its usage patterns.

Q: What is the likelihood of a severe allergic reaction to Flatoril?

A: Known hypersensitivity (allergy) to any component is listed as a contraindication. Severe allergic reactions are generally categorized as Rare or Very Rare in the overall safety profile, but a specific statistical frequency is not typically provided.

Q: Does Flatoril interfere with vitamins or mineral supplements?

A: Regulatory text notes that the drug's action of increased motility can potentially reduce the absorption of any concomitantly administered medicine. This general pharmacological principle applies to vitamins and mineral supplements.

Q: Is Flatoril a controlled substance?

A: Flatoril is not described in regulatory documents as being classified as a controlled substance under the relevant regulatory acts.

Q: Can Flatoril be used by people with diabetes?

A: There are no specific warnings or restrictions mentioned in the regulatory documentation regarding the use of Flatoril in patients with diabetes.

How should Flatoril be stored and disposed of?

How to Store and Dispose of Flatoril?

Storage Requirements

Flatoril hard capsules must be stored at a temperature below 30 C to maintain their established 36-month shelf life. The medication is supplied in a PVC/aluminium blister and must not be used after the expiration date on the packaging. To ensure safety, Flatoril must be stored out of the sight and reach of children.

Disposal Instructions

Unused or expired Flatoril must not be disposed of by pouring it down a sink or toilet or by throwing it into household trash. Official regulations require the product to be returned to a designated pharmaceutical waste collection point or pharmacy take-back program. If a take-back option is unavailable, alternative disposal methods should adhere to local guidance for non-flushable medicines.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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