Pharmacology
D-Metro (Metronidazole) is active against bacteria and protozoa with primarily anaerobic metabolism. Although Metronidazole enters into aerobic organisms, it is only in anaerobes that it is biochemically reduced to an active derivative which binds to DNA and inhibits further nucleic acid synthesis. D-Metro may also inhibit pyruvate and phosphate metabolism by inhibiting a hydrogenase occurring in clostridia and other anaerobes. Metronidazole is well absorbed from gastrointestinal tract and a single 200 mg oral dose produces a mean peak plasma level of 5 μg/ml at 1-2 hours, falling to 1 μg/ml after 24 hours. Single doses of 1 and 2.4 g produce peak levels of 26 and 45μg/ml respectively. Similar levels to those in plasma appear in milk, but in the suckling infant blood levels are low. The biological half-life of the drug is 6-8 hours. 15-60% is excreted in the feces. 
Indication
Acute amoebic dysentery, amoebic hepatitis, amoebic abscess in liver and other organs, amoebic cyst eradication, trichomonas infections, acute ulcerative gingivitis, giardia lamblia infestations, anaerobic infections due to Bacteroides fragilis, fusobacteria, clostridia, anaerobic Streptococci and eubacteria. Ulcer caused by Vincent's organisms, guinea worm infestations (dracontiasis), Dracunculus medinensis.
Dosage and Administration
If not otherwise prescribed by the physician, the following dosage schedule may be followed.

) A second course of treatment may be given, if needed after 4-5 weeks.
2) Concomitant treatment of sexual consorts is recommended.
3) In elderly women hormone therapy may be necessary to clear up reaginitis.
Side Effects
Metallic taste, furred tongue, nausea, vomiting, diarrhea, drowsiness, rashes and mild reversible leucopenia may be observed during treatment. It is thus a relatively safe drug although when used in large doses over several months, a few cases of severe peripheral neuropathy have occurred.
Precaution
Vaginitis due to organisms other than T. vaginalis does not respond to Metronidazole. This drug should be used in pregnancy only if clearly needed.
Contraindication
D-Metro is contraindicated in patients with a prior history of hypersensitivity to Metronidazole or other nitroimidazole derivatives.
Pharmaceutical Precaution
Store in a cool below 300 C, dry place and protect from light and moisture. Keep out of reach of children.
Packing
D-Metro-400 Tablet: Box containing 10 x 10 tablets in blister pack.
D-Metro Suspension: Amber glass bottle containing 60 ml suspension.