US2010120734A1PendingUtilityA1

Formoterol/steroid bronchodilating compositions and methods of use thereof

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Assignee: DEY L PPriority: Apr 17, 2001Filed: Jan 22, 2010Published: May 13, 2010
Est. expiryApr 17, 2021(expired)· nominal 20-yr term from priority
A61P 43/00A61K 31/56A61K 47/02A61K 31/573A61K 31/167A61P 11/00A61K 45/06A61P 11/06A61P 11/08A61K 31/537A61K 47/10A61K 9/0078A61K 31/58A61K 31/568A61K 31/191
54
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Claims

Abstract

Bronchodilating compositions and methods are provided. The compositions are intended for administration as a nebulized aerosol. In certain embodiments, the compositions contain formoterol, or a derivative thereof, and a steroidal anti-inflammatory agent. Methods for treatment, prevention, or amelioration of one or more symptoms of bronchoconstrictive disorders using the compositions provided herein are also provided.

Claims

exact text as granted — not AI-modified
1 . A pharmaceutical composition, comprising:
 (i) formoterol, or a pharmaceutically acceptable hydrate thereof in solution; and   (ii) a steroidal anti-inflammatory agent, or a pharmaceutically acceptable salt or hydrate thereof in suspension;   
       in a pharmacologically suitable fluid comprising water that is propellant-free, wherein;
 the composition is an aqueous composition formulated so that it is stable during long term storage, whereby the composition has an estimated shelf-life of greater than 1 month usage time at 25° C. and greater than or equal to 1 year storage time at 5° C., whereby greater than 90% of the initial amount of formoterol in the composition remains at such time; 
 the formoterol free base concentration is about 5 μg/mL to about 200 μg/mL; and 
 the composition is formulated at a concentration for direct administration to a human in need thereof. 
 
     
     
         2 . The pharmaceutical composition of  claim 1 , wherein greater than about 80% of the initial formoterol is present after 1 month usage time at 25° C. and 1 year storage time at 5° C. 
     
     
         3 . The pharmaceutical composition of  claim 1  that has been nebulized. 
     
     
         4 . The pharmaceutical composition of  claim 1 , wherein the pharmacologically suitable fluid further comprises a polar solvent. 
     
     
         5 . The pharmaceutical composition of  claim 4 , wherein the polar solvent is a protic solvent. 
     
     
         6 . The pharmaceutical composition of  claim 5 , further comprising a tonicity adjusting agent. 
     
     
         7 . The pharmaceutical composition of  claim 6 , wherein the tonicity adjusting agent is ammonium carbonate, ammonium chloride, ammonium lactate, ammonium nitrate, ammonium phosphate, ammonium sulfate, ascorbic acid, bismuth sodium tartrate, boric acid, calcium chloride, calcium disodium edetate, calcium gluconate, calcium lactate, citric acid, dextrose, diethanolamine, dimethylsulfoxide, edetate disodium, edetate trisodium monohydrate, fluorescein sodium, fructose, galactose, glycerin, lactic acid, lactose, magnesium chloride, magnesium sulfate, mannitol, polyethylene glycol, potassium acetate, potassium chlorate, potassium chloride, potassium iodide, potassium nitrate, potassium phosphate, potassium sulfate, propylene glycol, silver nitrate, sodium acetate, sodium bicarbonate, sodium biphosphate, sodium bisulfite, sodium borate, sodium bromide, sodium cacodylate, sodium carbonate, sodium chloride, sodium citrate, sodium iodide, sodium lactate, sodium metabisulfite, sodium nitrate, sodium nitrite, sodium phosphate, sodium propionate, sodium succinate, sodium sulfate, sodium sulfite, sodium tartrate, sodium thiosulfate, sorbitol, sucrose, tartaric acid, triethanolamine, urea, urethan, uridine or zinc sulfate. 
     
     
         8 . The pharmaceutical composition of  claim 7 , wherein the tonicity adjusting agent is sodium chloride. 
     
     
         9 . The pharmaceutical composition of  claim 1 , wherein the pharmacologically suitable fluid comprises a buffer. 
     
     
         10 . The pharmaceutical composition of  claim 9 , wherein the buffer is citric acid/phosphate, acetate, barbital, borate, cacodylate, citrate, collidine, formate, maleate, phosphate, succinate, citrate-phosphate-borate (Teorell-Stanhagen), veronal acetate, MES (2-(N-morpholino)ethanesulfonic acid), BIS-TRIS (bis(2-hydroxyethyl)iminotris-(hydroxymethyl)methane), ADA (N-(2-acetamido)-2-iminodiacetic acid), ACES (N-(carbamoylmethyl)-2-amino-ethanesulfonic acid), PIPES (piperazine-N,N′-bis(2-ethanesulfonic acid)), MOPSO (3-(N-morpholino)-2-hydroxypropanesulfonic acid), BIS-TRIS PROPANE (1,3-bis(tris(hydroxymethyl)methylamino)propane), BES (N,N-bis(2-hydroxyethyl)-2-aminoethanesulfonic acid), MOPS (3-(N-morpholino)propanesulfonic acid), TES (N-tris(hydroxymethyl)methyl-2-aminoethanesulfonic acid), HEPES (N-(2-hydroxyethyl)piperazine-N′-(2-ethanesulfonic acid), DIPSO (3-(N,N-bis(2-hydroxyethyl)amino)-2-hydroxypropanesulfonic acid), MOBS (4-(N-morpholino)butanesulfonic acid), TAPSO (3-(N-tris(hydroxymethyl)methylamino)-2-hydroxy-propanesulfonic acid), tris(hydroxymethylaminomethane, HEPPSO(N-(2-hydroxyethyl)piperazine-N 1 -(2-hydroxypropanesulfonic acid), POPSO (piperazine-N,N′-bis(2-hydroxypropane-sulfonic acid)), TEA (triethanolamine), EPPS(N-(2-hydroxyethyl)piperazine-1-N′-(3-propanesulfonic acid), TRICINE (N-tris(hydroxymethyl)methylglycine)-, GLY-GLY (glycylglycine), WINE (N,N-bis(2-hydroxyethyl)glycine), HEPBS (N-(2-hydroxyethyl)piperazine-N′-(4-butanesulfonic acid)), TAPS(N-tris(hydroxymethyl)methyl-3-aminopropanesulfonic acid), or AMPD (2-amino-2-methyl-1,3-propanediol) buffer. 
     
     
         11 . The pharmaceutical composition of  claim 10 , wherein the buffer is citrate buffer. 
     
     
         12 . The pharmaceutical composition of  claim 11 , wherein the buffer concentration is from about 0.01 mM to about 150 mM. 
     
     
         13 . The pharmaceutical composition of  claim 12 , wherein the buffer concentration is from about 1 mM to about 20 mM. 
     
     
         14 . The pharmaceutical composition of  claim 13 , wherein the buffer concentration is about 5 mM. 
     
     
         15 . The pharmaceutical composition of  claim 7 , wherein the ionic strength of the composition is about 0 to about 0.4. 
     
     
         16 . The pharmaceutical composition of  claim 15 , wherein the ionic strength of the composition is about 0.05 to about 0.16. 
     
     
         17 . The pharmaceutical composition of  claim 1 , wherein the pH of the composition is about 2.0 to about 8.0. 
     
     
         18 . The pharmaceutical composition of  claim 17 , wherein the pH of the composition is about 4.0 to about 6.0. 
     
     
         19 . The pharmaceutical composition of  claim 18 , wherein the pH of the composition is about 4.5 to about 5.5. 
     
     
         20 . The pharmaceutical composition of  claim 19 , wherein the pH of the composition is about 5.0. 
     
     
         21 . The pharmaceutical composition of  claim 1 , wherein the formoterol free base concentration is about 10 μg/mL to about 200 μg/mL. 
     
     
         22 . The pharmaceutical composition of  claim 21 , wherein the formoterol free base concentration is about 50 g/mL to about 200 μg/mL. 
     
     
         23 . The pharmaceutical composition of  claim 22 , wherein the formoterol free base concentration is about 59 μg/mL. 
     
     
         24 . The pharmaceutical composition of  claim 22 , wherein the formoterol free base concentration is about 118 μg/mL. 
     
     
         25 . The pharmaceutical composition of  claim 7 , further comprising a buffer. 
     
     
         26 . The pharmaceutical composition of  claim 25 , wherein the buffer is citric acid/phosphate, acetate, barbital, borate, cacodylate, citrate, collidine, formate, maleate, phosphate, succinate, citrate-phosphate-borate (Teorell-Stanhagen), veronal acetate, MES (2-(N-morpholino)ethanesulfonic acid), BIS-TRIS (bis(2-hydroxyethyl)iminotris-(hydroxymethyl)methane), ADA (N-(2-acetamido)-2-iminodiacetic acid), ACES (N-(carbamoylmethyl)-2-amino-ethanesulfonic acid), PIPES (piperazine-N,N′-bis(2-ethanesulfonic acid)), MOPSO (3-(N-morpholino)-2-hydroxypropanesulfonic acid), BIS-TRIS PROPANE (1,3-bis(tris(hydroxymethyl)methylamino)propane), BES (N,N-bis(2-hydroxyethyl)-2-aminoethanesulfonic acid), MOPS (3-(N-morpholino)propanesulfonic acid), TES (N-tris(hydroxymethyl)methyl-2-aminoethanesulfonic acid), HEPES (N-(2-hydroxyethyl)piperazine-N-(2-ethanesulfonic acid), DIPSO (3-(N,N-bis(2-hydroxyethyl)amino)-2-hydroxypropanesulfonic acid), MOBS (4-(N-morpholino)butanesulfonic acid), TAPSO (3-(N-tris(hydroxymethyl)methylamino)-2-hydroxy-propanesulfonic acid), tris(hydroxymethylaminomethane, HEPPSO(N-(2-hydroxyethyl)piperazine-N′-(2-hydroxypropanesulfonic acid), POPSO (piperazine-N,N′-bis(2-hydroxypropane-sulfonic acid)), TEA (triethanolamine), EPPS(N-(2-hydroxyethyl)piperazine-N′-(3-propanesulfonic acid), TRICINE (N-tris(hydroxymethyl)methylglycine-), GLY-GLY (glycylglycine), BICINE (N,N-bis(2-hydroxyethyl)glycine), HEPBS (N-(2-hydroxyethyl)piperazine-N′-(4-butanesulfonic acid)), TAPS(N-tris(hydroxyl-methyl)methyl-3-aminopropanesulfonic acid), or AMPD (2-amino-2-methyl-1,3-propanediol) buffer. 
     
     
         27 . The pharmaceutical composition of  claim 26 , wherein the buffer is citrate buffer. 
     
     
         28 . The pharmaceutical composition of  claim 27 , wherein the buffer concentration is from about 0.01 mM to about 150 mM. 
     
     
         29 . The pharmaceutical composition of  claim 28 , wherein the buffer concentration is from about 1 mM to about 20 mM. 
     
     
         30 . The pharmaceutical composition of  claim 29 , wherein the buffer concentration is about 5 mM. 
     
     
         31 . The pharmaceutical composition of  claim 25 , wherein the ionic strength of the composition is about 0 to about 0.4. 
     
     
         32 . The pharmaceutical composition of  claim 31 , wherein the ionic strength of the composition is about 0.05 to about 0.16. 
     
     
         33 . The pharmaceutical composition of  claim 25 , wherein the pH of the composition is about 2.0 to about 8.0. 
     
     
         34 . The pharmaceutical composition of  claim 33 , wherein the pH of the composition is about 4.0 to about 6.0. 
     
     
         35 . The pharmaceutical composition of  claim 34 , wherein the pH of the composition is about 4.5 to about 5.5. 
     
     
         36 . The pharmaceutical composition of  claim 35 , wherein the pH of the composition is about 5.0. 
     
     
         37 . The pharmaceutical composition of  claim 25 , wherein the formoterol free base concentration is about 10 μg/mL to about 200 μg/mL. 
     
     
         38 . The pharmaceutical composition of  claim 37 , wherein the formoterol free base concentration is about 50 μg/mL to about 200 μg/mL. 
     
     
         39 . The pharmaceutical composition of  claim 38 , wherein the formoterol free base concentration is about 59 μg/mL. 
     
     
         40 . The pharmaceutical composition of  claim 38 , wherein the formoterol free base concentration is about 118 μg/mL. 
     
     
         41 . The pharmaceutical composition of  claim 23  that has been nebulized. 
     
     
         42 . The pharmaceutical composition of  claim 24  that has been nebulized. 
     
     
         43 . The pharmaceutical composition of  claim 39  that has been nebulized. 
     
     
         44 . The pharmaceutical composition of  claim 40  that has been nebulized. 
     
     
         45 . The pharmaceutical composition of  claim 25  that has been nebulized. 
     
     
         46 . The pharmaceutical composition of  claim 39 , wherein the buffer is citrate buffer. 
     
     
         47 . The pharmaceutical composition of  claim 39 , wherein the buffer concentration is about 5 mM. 
     
     
         48 . The pharmaceutical composition of  claim 39 , wherein the ionic strength of the composition is about 0.05 to about 0.16. 
     
     
         49 . The pharmaceutical composition of  claim 39 , wherein the pH of the composition is about 5.0. 
     
     
         50 . The pharmaceutical composition of  claim 39 , wherein the buffer is citrate buffer; the buffer concentration is about 5 mM; the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         51 . The pharmaceutical composition of  claim 40 , wherein the buffer is citrate buffer. 
     
     
         52 . The pharmaceutical composition of  claim 40 , wherein the buffer concentration is about 5 mM. 
     
     
         53 . The pharmaceutical composition of  claim 40 , wherein the ionic strength of the composition is about 0.05 to about 0.16. 
     
     
         54 . The pharmaceutical composition of  claim 40 , wherein the pH of the composition is about 5.0. 
     
     
         55 . The pharmaceutical composition of  claim 40 , wherein the buffer is citrate buffer; the buffer concentration is about 5 mM; the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         56 . The pharmaceutical composition of  claim 50  that has been nebulized. 
     
     
         57 . The pharmaceutical composition of  claim 55  that has been nebulized. 
     
     
         58 . The pharmaceutical composition of  claim 10 , wherein the buffer comprises citric acid/phosphate buffer, acetate buffer, citrate buffer or phosphate buffer. 
     
     
         59 . The pharmaceutical composition of  claim 25 , wherein the buffer comprises citric acid/phosphate buffer, acetate buffer, citrate buffer or phosphate buffer. 
     
     
         60 . The pharmaceutical composition of  claim 1 , wherein the steroidal anti-inflammatory agent is beclomethasone dipropionate, beclomethasone monopropionate, flunisolide, triamcinolone acetonide, dexamethasone, tipredane, ciclesonid, rofleponide, mometasone, mometasone furoate, RPR 106541 having the formula 
       
         
           
           
               
               
           
         
         fluticasone or fluticasone propionate or budesonide, or a pharmaceutically acceptable salt or hydrate thereof. 
       
     
     
         61 . The pharmaceutical composition of  claim 60 , wherein the steroidal anti-inflammatory agent is budesonide or fluticasone propionate, or a pharmaceutically acceptable salt or hydrate thereof. 
     
     
         62 . The pharmaceutical composition of  claim 61 , wherein the steroidal anti-inflammatory agent is budesonide, or a derivative thereof. 
     
     
         63 . The pharmaceutical composition of  claim 62 , wherein the budesonide concentration is about 5 μg/mL to about 2 mg/mL. 
     
     
         64 . The pharmaceutical composition of  claim 62 , wherein the budesonide concentration is about 75 μg/mL to about 500 μg/mL. 
     
     
         65 . The pharmaceutical composition of  claim 62 , wherein the budesonide concentration is about 125 μg/mL or about 250 μg/mL. 
     
     
         66 . The pharmaceutical composition of  claim 61 , wherein the steroidal anti-inflammatory agent is fluticasone propionate. 
     
     
         67 . The pharmaceutical composition of  claim 66 , wherein the concentration of fluticasone propionate is about 5 μg/mL to about 2 mg/mL. 
     
     
         68 . The pharmaceutical composition of  claim 67 , wherein the concentration of fluticasone propionate is about 75 μg/mL to about 1000 μg/mL. 
     
     
         69 . The pharmaceutical composition of  claim 68 , wherein the concentration of fluticasone propionate is about 125 μg/mL or about 250 μg/mL. 
     
     
         70 . The pharmaceutical composition of  claim 50 , wherein the steroidal anti-inflammatory agent is budesonide or fluticasone propionate. 
     
     
         71 . The pharmaceutical composition of  claim 55 , wherein the steroidal anti-inflammatory agent is budesonide or fluticasone propionate. 
     
     
         72 . A kit, comprising:
 (a) an aqueous composition comprising
 (i) formoterol or a pharmaceutically acceptable salt or hydrate thereof in solution, wherein the formoterol is present at a concentration of 5 μg/mL to about 200 μg/mL; and 
 (ii) a steroidal anti-inflammatory agent or a pharmaceutically acceptable salt or hydrate thereof in suspension, formulated for single dosage administration, wherein the aqueous composition is propellant-free and has an estimated shelf-life of greater than 1 month usage time at 25° C. and greater than or equal to 1 year storage time at 5° C.; and 
   (b) a nebulizer.   
     
     
         73 . The kit of  claim 72 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 59 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 5 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         74 . The kit of  claim 72 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 118 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 5 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         75 . A combination, comprising:
 (a) the pharmaceutical composition of  claim 1  formulated for single dosage administration; and   (b) a vial.   
     
     
         76 . The combination of  claim 75 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 59 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 5 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         77 . The combination of  claim 75 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 118 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 5 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         78 . An article of manufacture, comprising packaging material, an aqueous composition comprising the composition of  claim 1  formulated for single dosage administration, which is useful for treatment or amelioration of one or more symptoms of diseases or disorders associated with undesired and/or uncontrolled bronchoconstriction, and a label that indicates that the composition is used for treatment, amelioration of one or more symptoms of diseases or disorders associated with undesired and/or uncontrolled bronchoconstriction. 
     
     
         79 . An article of manufacture, comprising packaging material, the composition of  claim 70  formulated for single dosage administration, which is useful for treatment or amelioration of one or more symptoms of diseases or disorders associated with undesired and/or uncontrolled bronchoconstriction, and a label that indicates that the composition is used for treatment or amelioration of one or more symptoms of diseases or disorders associated with undesired and/or uncontrolled bronchoconstriction. 
     
     
         80 . An article of manufacture, comprising packaging material, the composition of  claim 71  formulated for single dosage administration, which is useful for treatment or amelioration of one or more symptoms of diseases or disorders associated with undesired and/or uncontrolled bronchoconstriction, and a label that indicates that the composition is used for treatment or amelioration of one or more symptoms of diseases or disorders associated with undesired and/or uncontrolled bronchoconstriction. 
     
     
         81 . The pharmaceutical composition of  claim 1 , further comprising one or more of (a) to (j) as follows: (a) a β 2 -adrenoreceptor agonist; (b) a dopamine (D 2 ) receptor agonist; (c) an IL-5 inhibitor; (d) an antisense modulator of IL-5; (e) a tryptase inhibitor; (f) a tachykinin receptor antagonist; (g) milrinone or milrinone lactate; (h) a leukotriene receptor antagonist; (i) a 5-lypoxygenase inhibitor; or (j) an anti-IgE antibody. 
     
     
         82 . The pharmaceutical composition of  claim 12 , wherein the buffer concentration is from about 1 mM to about 50 mM. 
     
     
         83 . The pharmaceutical composition of  claim 82 , wherein the buffer concentration is about 20 mM. 
     
     
         84 . The pharmaceutical composition of  claim 28 , wherein the buffer concentration is from about 1 mM to about 50 mM. 
     
     
         85 . The pharmaceutical composition of  claim 84 , wherein the buffer concentration is about 20 mM. 
     
     
         86 . The pharmaceutical composition of  claim 39 , wherein the buffer concentration is about 20 mM. 
     
     
         87 . The pharmaceutical composition of  claim 39 , wherein the buffer is citrate buffer; the buffer concentration is about 20 mM; the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         88 . The pharmaceutical composition of  claim 40 , wherein the buffer concentration is about 20 mM. 
     
     
         89 . The pharmaceutical composition of  claim 40 , wherein the buffer is citrate buffer; the buffer concentration is about 20 mM; the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         90 . The pharmaceutical composition of  claim 87  that has been nebulized. 
     
     
         91 . The pharmaceutical composition of  claim 89  that has been nebulized. 
     
     
         92 . The kit of  claim 72 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 59 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 20 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         93 . The kit of  claim 72 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 118 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 20 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         94 . The combination of  claim 75 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 59 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 20 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         95 . The combination of  claim 75 , wherein the aqueous composition comprises (a) formoterol free base at a concentration of about 118 μg/mL; (b) aqueous saline comprising sodium chloride; and (c) citrate buffer at a concentration of about 20 mM; wherein the ionic strength of the composition is about 0.05 to about 0.16; and the pH of the composition is about 5.0. 
     
     
         96 . The pharmaceutical composition of  claim 1 , further comprising an anticholinergic agent. 
     
     
         97 . The pharmaceutical composition of  claim 96 , wherein the anticholinergic agent is ipratropium bromide, oxitropium bromide, atropine methyl nitrate, tiotropium bromide or glycopyrronium bromide. 
     
     
         98 . The pharmaceutical composition of  claim 97 , wherein the anticholinergic agent is ipratropium bromide. 
     
     
         99 . The pharmaceutical composition of  claim 98 , wherein the ipratropium bromide is present at a concentration of about 5 μg/mL to about 5 mg/mL. 
     
     
         100 . A combination, comprising:
 (a) a composition comprising formoterol, or a pharmaceutically acceptable salt or hydrate thereof in solution, the composition being in a pharmacologically suitable fluid comprising water that is propellant-free, and the composition having an estimated shelf-life of greater than 1 month usage time at 25° C. and greater than or equal to 1 year storage time when stored at 5° C. whereby greater than 90% of the initial amount of formoterol in the compositions remains at such time; the formoterol free base concentration is about 5 μg/mL to about 200 μg/mL, and the composition is formulated at a concentration for direct administration to a human in need thereof; and   (b) a composition comprising a bronchodilating steroid, or a pharmaceutically acceptable salt or hydrate thereof in suspension.   
     
     
         101 . The combination of  claim 100 , further comprising a nebulizer. 
     
     
         102 . The combination of  claim 101  that is packaged as a kit; optionally comprising instructions for use of the nebulizer; and optionally comprising instructions for mixing the compositions. 
     
     
         103 . The pharmaceutical composition of  claim 97 , wherein the anticholinergic agent is tiotropium bromide. 
     
     
         104 . The pharmaceutical composition of  claim 98 , wherein the tiotropium bromide is present at a concentration of about 5 μg/mL to about 5 mg/mL. 
     
     
         105 . A pharmaceutical composition, comprising:
 (i) formoterol, or a pharmaceutically acceptable salt or hydrate thereof in solution, at a concentration with reference to the free base of about 5 μg/mL to about 200 μg/mL; and   (ii) a steroid anti-inflammatory agent, or a pharmaceutically acceptable salt or hydrate thereof in suspension; in a pharmacologically suitable fluid comprising water, which is propellant-free, wherein:   the composition is an aqueous composition that contains buffer at a concentration of 1-20 mM, has a pH of 4 to 6, an ionic strength of 0.05-0.16, selected so that the composition has an estimated shelf-life of greater than 1 month usage time at 25° C. and greater than or equal to 1 year storage time at 5° C.   
     
     
         106 . The pharmaceutical composition of  claim 1 , wherein the formoterol is formoterol fumarate dihydrate; and the steroidal anti-inflammatory agent is fluticasone propionate. 
     
     
         107 . The pharmaceutical composition of  claim 106 , wherein the concentration of fluticasone propionate in the composition is about 75 μg/mL to about 1000 μg/mL. 
     
     
         108 . The pharmaceutical composition of  claim 107 , wherein the concentration of fluticasone propionate in the composition is about 250 μg/mL to about 1000 μg/mL. 
     
     
         109 . The pharmaceutical composition of  claim 107 , wherein the concentration of fluticasone propionate in the composition is about 125 μg/mL to about 250 μg/mL 
     
     
         110 . The pharmaceutical composition of  claim 106 , wherein the composition further comprises a tonicity adjusting agent, a suspension stabilizer, and the pharmaceutically suitable fluid comprises a buffer. 
     
     
         111 . The pharmaceutical composition of  claim 110 , wherein the tonicity adjusting agent comprises sodium chloride and sodium edetate, the suspension stabilizer is Polysorbate 80, and the buffer is a sodium citrate buffer. 
     
     
         112 . A sterile unit dose, comprising:
 (a) a pharmaceutical composition comprising formoterol or a salt thereof at a concentration of from about 5 μg/mL to about 200 μg/mL based on formoterol free base, in a pharmacologically suitable solution, wherein the composition further comprises water and a buffer having a concentration of from about 1 mM to about 50 mM, said composition having a pH of about 4.0 to about 6.0, and having an estimated shelf life of greater than 90% after 3 months storage at 25° C. and after 3 years storage at 5° C.;   (b) packaged in a pharmaceutical packaging material.   
     
     
         113 . The sterile unit dose as in any one of  claims 112  wherein said buffer is selected from the group consisting of a citric acid/phosphate buffer, acetate buffer, citrate buffer or phosphate buffer. 
     
     
         114 . The sterile unit dose of  claim 113  wherein said buffer is present at a concentration of between about 1 mM and about 20 mM. 
     
     
         115 . The sterile unit dose as in any one of  claims 112  wherein said pharmaceutical packaging material is selected from the group consisting of blister packs, bottles, tubes, inhalers, pumps, bags, vials, containers and syringes. 
     
     
         116 . The sterile unit dose of  claim 115  wherein said pharmaceutical packaging material is a vial. 
     
     
         117 . The sterile unit dose as in any one of  claims 112 , wherein said buffer has a concentration of from about 1 mM to about 20 mM. 
     
     
         118 . The sterile unit dose as in any one of  claims 112 , wherein said composition has a pH of about 5. 
     
     
         119 . The sterile unit dose of  claim 117 , wherein said buffer has a pH of about 5. 
     
     
         120 . The sterile unit dose as in any one of  claims 112 , wherein said formoterol or a salt thereof is formoterol tartrate. 
     
     
         121 . The sterile unit dose of  claim 117 , wherein said formoterol or a salt thereof is formoterol tartrate. 
     
     
         122 . A sterile unit dose, comprising:
 (a) a pharmaceutical composition comprising formoterol or a salt thereof at a concentration of from about 5 μg/mL to about 200 μg/mL based on formoterol free base, in a pharmacologically suitable solution, wherein the composition further comprises water and a buffer selected from the group consisting of citric acid/phosphate buffer, acetate buffer, citrate buffer or phosphate buffer at a concentration of from about 1 mM to about 50 mM, said composition having a pH of about 4.5 to about 5.5;   (b) packaged in a pharmaceutical packaging material.   
     
     
         123 . The sterile unit dose of  claim 122 , wherein said pharmaceutical packaging material is a vial. 
     
     
         124 . The sterile unit dose of  claim 122 , wherein said buffer has a concentration of from about 1 mM to about 20 mM. 
     
     
         125 . The sterile unit dose of  claim 122 , wherein said composition has a pH of about 5. 
     
     
         126 . The sterile unit dose of  claim 124 , wherein said buffer has a pH of about 5. 
     
     
         127 . The sterile unit dose of  claim 122 , wherein said formoterol or a salt thereof is formoterol tartrate. 
     
     
         128 . The sterile unit dose of  claim 124 , wherein said formoterol or a salt thereof is formoterol tartrate. 
     
     
         129 . The sterile unit dose of  claim 126 , wherein said formoterol or a salt thereof is formoterol tartrate.

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