Estradiol vaginal tablets provides an effective alternative to traditional forms of local estrogen therapy.

Eight patients were given flunitrazepam 2 mg orally, once daily for 28 consecutive days. The time-course of the plasma concentration of unchanged flunitrazepam and its principal metabolites were studied in detail after the first and last doses. Additional blood samples were collected immediately before administration of the tablet on days 4, 7, 11, 14, 18, 21 and 25. Clinically there were not changes during the trial period in the onset of sleep, duration of sleep, depth of sleep measured as number of spontaneous awakenings, or in the patients' condition on awakening. The time-course of the plasma concentration of flunitrazepam could be described by a three-compartment model, assuming that the rate constants remained unchanged during treatment. Maximal plasma concentrations of unchanged flunitrazepam, found two hours after intake, reached 10-15 ng/ml after the first and 15-20 ng/ml after the last dose. The beta-half-life was found to be between 20 and 36 h.

The hypnotic effect and tolerance of zopiclone 7.5 mg, nitrazepam 5 mg, flurazepam 30 mg, flunitrazepam 2 mg and placebo were compared in a one-night double blind study in 414 hospitalised patients who were to undergo an operation on the following day. Zopiclone was slightly superior to nitrazepam but was inferior both to flurazepam and flunitrazepam. All the active drugs differed clearly from placebo. The results from a subset of patients, excluding those who felt anxious either before treatment on the evening prior to the operation or on the following morning, were analysed separately. All the active products differed significantly from placebo; zopiclone was slightly less effective than the three benzodiazepines. All the benzodiazepines decreased the percentage of patients feeling anxious about the operation by about 25%, zopiclone by about 10% and placebo did not change it at all.

Day-time sleep and residual effects of quazepam 15 mg, triazolam 0.25 mg, flunitrazepam I mg, and placebo, alone and in combination with ethanol, were studied using a randomized, double-blind, crossover, single-dose design. Eight healthy volunteers, four male and four female, aged 19-24 years, received each medication in the morning after a 'normal' sleep at home the preceding night.Quazepam and triazolam decreased the sleep onset when compared to placebo. The combination with ethanol did not change these findings. Quazepam and placebo showed less residual effects than triazolam and flunitrazepam at 4 hours after drug intake: in combination with ethanol at 4 and 6 hours. No significant differences in mood were found between the different 'treatments', except with regard to alertness for quazepam and placebo compared to flunitrazepam, alone and in combination with ethanol, all at 4 hours.The combination druglethano1 showed an increase in C,,, of the former and a delay in T,,,, when compared to drug alone. The study indicated few clinically useful correlations between clinical effect and plasma concentration.