FUMARATE AND ACLIDINIUM: BROMIDE

PRIORITY STATEMENT

[0001] This application claims the benefit of U.S. Provisional Patent Application No.

62/867,838 filed on June 27, 2019, which is incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

[0002] Aclidinium and its synthetic preparation has been described in WO 01/04118 and W 02008/009397. Aclidinium may be in the form of a bromide salt as aclidinium bromide, chemi cal ly known as 3 (R)-(2-hydroxy-2,2-dithi en-2-yl acetoxy)- 1 -(3 -phenoxypropyl )- 1 - azoniabicy- clo [2.2.2] octane bromide, which has the following chemical structure:

[0003] Aclidinium bromide is a white to off-white crystalline powder. Aclidinium bromide is a muscarinic antagonist and is commercially available. Aclidinium bromide is a long-acting anticholinergic approved for long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.

[0004] Formoterol, chemically known as N-[2-hydroxy-5-(l-hydroxy-2-((2-(4- methoxyphenyl)-l -methyl ethy- 1) amino)-ethyl) phenyl] formamide, has been described in US3994974. Formoterol may be in the form of a fumarate salt, as formoterol fumarate, which has the following chemical structure:

[0005] Formoterol fumarate, as a long-acting beta 2 -adrenergic receptor agonist, is a bronchodilator used in the treatment of obstructive airways diseases. It can be used to treat asthma, shortness of breath, and breathing difficulties caused by chronic obstructive pulmonary disease, as well as a group of lung diseases including chronic bronchitis and emphysema in adults. Inhaled formoterol fumarate acts locally in the lung to expand the airways. Both formoterol fumarate and aclidinium bromide can provide therapeutic benefits for the treatment of asthma and chronic obstructive pulmonary disease.

[0006] The present invention relates to a propellant-free inhalable formulation of formoterol or a pharmaceutically acceptable salt thereof, such as formoterol fumarate, and aclidinium or a pharmaceutically acceptable salt thereof, such as aclidinium bromide, dissolved in a mixture of water and ethanol, preferably administered by a soft mist or nebulization inhalation device, and propellant-free inhalable aerosols resulting therefrom. The pharmaceutical formulations disclosed in the current invention are especially suitable for soft mist inhalation or nebulization inhalation, which have good lung depositions, typically up to 55-60%, compared to the dry- powder inhalation method. Furthermore, liquid inhalation formulations are advantageous compared to dry powder inhalation formulations. Administration by dry powder inhalation is more difficult, particularly for children and elderly patients.

[0007] The pharmaceutical formulation of the present invention is particularly suitable for administering active substances by soft mist or nebulization inhalation, especially for treating asthma and chronic obstructive pulmonary- disease.

SUMMARY OF THE INVENTION

[0008] Aspects and advantages of the invention will be set forth in part in the following description, or may be obvious from the description, or may be learned through practice of the invention.

[0009] The present invention relates to pharmaceutical formulations of aclidinium and formoterol, and their pharmaceutically acceptable salts or solvates, such as aclidinium bromide and formoterol fumarate, which can be administered by soft mist or nebulization inhalation. The pharmaceutical formulations according to the invention meet high quality standards

[0010] One aspect of the present invention is to provide an aqueous pharmaceutical formulation containing formoterol fumarate and aclidinium bromide, which meets the high standards needed in order to be able to achieve optimum nebulization of a solution using the inhalers mentioned hereinbefore. A pharmaceutically stable pharmaceutical formulation may be stable for a storage time of some years, for example one year, or for example three years.

[0011] Another aspect of the invention is to provide propellant-free formulations of solutions containing formoterol fumarate and aclidinium bromide which are nebulized under pressure using an inhaler which may be a soft mist or nebulization inhal er device. Compositions of the invention may be delivered as an aerosol having reproducible characteristics within a specified range.

[0012] More specifically, another aspect of the invention is to provide stable pharmaceutical formulations of aqueous solutions containing formoterol fumarate, aclidinium bromide, and pharmaceutically acceptable excipients which can be administered by soft mist or nebulization inhalation.

[0013] These and other features, aspects and advantages of the present invention will become better understood with reference to the following description and appended claims. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description, serve to explain the principles of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

[0014] A full and enabl ing disclosure of the present invention, including the best mode thereof, directed to one of ordinary skill in the art, is set forth in the specification, which makes reference to the appended figures, in which:

[0015] Figure 1 shows a longitudinal section through an atomizer in the stressed state;

[0016] Figure 2 shows a counter element of the atomizer;

[0017] Figure 3 shows sample 13 particle size distribution of droplets sprayed by a soft mist inhaler in example 7;

[0018] Figure 4 shows sample 13 particle size distribution of droplets sprayed by a compressed air nebulizer in example 7;

[0019] Figure 5 shows sample 13 particle size distribution of droplets sprayed by an ultrasonic vibrating mesh nebulizer in example 7;

[0020] Figure 6 shows sample 14 particle size distribution of droplets sprayed by a soft mist inhaler in example 7; [0021] Figure 7 shows sample 14 particle size distribution of droplets sprayed by a compressed air nebulizer in example 7;

[0022] Figure 8 shows sample 14 particle size distribution of droplets sprayed by an ultrasonic vibrating mesh nebulizer in example 7;

[0023] Figure 9 shows sample 15 particle size distribution of droplets sprayed by a soft mist inhaler in example 7;

[0024] Figure 10 shows sample 15 particle size distribution of droplets sprayed by a compressed air nebulizer in example 7;

[0025] Figure 11 show's sample 15 particle size distribution of droplets sprayed by an ultrasonic vibrating mesh nebulizer in example 7;

[0026] Figure 12 shows aerodynamic particle size distribution of aclidinium bromide in example 8; and

[0027] Figure 13 shows aerodynamic particle size distribution of formoterol fumarate in example 8.

[0028] The use of identical or similar reference numerals in different figures denotes identical or similar features.

DETAILED DESCRIPTION OF THE INVENTION

[0029] For purposes of describing the invention, reference now will be made in detail to embodiments and/or methods of the invention, one or more examples of which are illustrated in or with the drawings. Each example is provided by way of explanation of the invention, not limitation of the invention. In fact, it will be apparent to those skilled in the art that various modifications and variations can be made in the present invention without departing from the scope or spirit of the invention. For instance, features or steps illustrated or described as part of one embodiment, can be used with another embodiment or steps to yield still further

embodiments or methods. Thus, it is intended that the present invention covers such

modifications and variations as come within the scope of the appended claims and their equivalents.

[0030] It is desirable to use a liquid formulation without propellant gases, administered using suitable inhalers, in order to achieve a better distribution of active substances in the lung.

Furthermore, it is desirable to increase the lung deposition of the drug delivered by inhalation. [0031] Currently, the traditional pMDI or DPI (dry powder inhalation) device can only deliver about 20-30% of drug from a formulation into the lung, resulting in a significant amount of drug deposited in the month and throat, which ends up in the stomach and may cause unwanted side effects and/or secondary absorption through the digestive system.

[0032] Therefore, there is a need to improve inhalation drug delivery by increasing lung deposition. The soft mist or nebulization inhalation device disclosed in US20190030268 can significantly increase the lung deposition of inhalable drugs.

[0033] Such inhalers can nebulize a small amount of a liquid formulation within a few seconds into an aerosol suitable for therapeutic inhalation. Such inhalers are particularly suitable to administer the liquid formulation of the present invention.

[0034] The soft mist or nebulization devices suitable for administering the aqueous pharmaceutical formulation of the present invention are those in which an amount of less than about 70 microliters of pharmaceutical solution can be nebulized in one puff, such as less than about 30 microliters, more particularly less than about 15 microliters, so that the inhalable part of the aerosol corresponds to a therapeutically effective quantity. The average particle size of the aerosol formed from one puff is less than about 15 microns, or less than about 10 microns.

[0035] A device of this kind for the propellant-free administration of a metered amount of a liquid pharmaceutical composition for inhalation is described in detail, for example, in

US20190030268.

[0036] The pharmaceutical formulation solution in the nebulizer is converted into aerosol destined for the lungs. The pharmaceutical solution is sprayed by the nebulizer using high pressure.

[0037] In certain inhalers that can be used with the invention, the pharmaceutical solution is stored in a reservoir. In an embodiment, the pharmaceutical solution formulations of the invention do not contain any ingredients which might interact with the inhaler to affect the pharmaceutical quality of the formulation or of the aerosol produced. In an embodiment, the pharmaceutical formulations of the invention are very stable when stored and can be

administered directly.

[0038] In an embodiment, the pharmaceutical solution formulations of the current invention contain additives, such as the di sodium salt of edetic acid (sodium edetate), to reduce the incidence of spray anomalies and to stabilize the formulation solutions. In an embodiment, the aqueous pharmaceutical solution formulations of the invention have a low concentration of sodium edetate.

[0039] Therefore, one aspect of the present invention is to provide an aqueous

pharmaceutical formulation containing formoterol fumarate and aclidinium bromide, which meets the high standards needed in order to be able to achieve optimum nebulization of a solution using the inhalers mentioned hereinbefore. In an embodiment, the active substances in the pharmaceutical formulation are stable for a storage time of some years, for example one year, or for example three years.

[0040] Another aspect of the current invention is to provide propellant-free formulations of solutions containing formoterol fumarate and aclidinium bromide, which are nebulized under pressure using an inhaler, such as soft mist inhalers or other nebulization inhalers. Compositions of the invention may be delivered by aerosol having reproducible characteristics within a specified range.

[0041] Another aspect is to provide an aqueous pharmaceutical solution formulation containing formoterol fumarate and aclidinium bromide and inactive excipients which can be administered by inhalation. According to the invention, any pharmaceutically acceptable salts or solvates of formoterol and aclidinium may be used for the formulation. In an embodiment, the salts of formoterol and aclidinium are formoterol fumarate and aclidinium bromide. In an embodiment, the active substances are selected from combinations of formoterol fumarate and aclidinium bromide.

[0042] In an embodiment, the formoterol fumarate and aclidinium bromide are dissolved in a solvent. The solvent may be a mixture of water and ethanol. Ethanol may he added to the formulation in order to increase the solubility of additives or other active substances. In an embodiment, the relative proportion of ethanol to water is about 20:80 (v/v) to about 30:70 (v/v).

[0043] In an embodiment, ethanol is present in the solvent at about 5% to about 30% by volume, more specifically about 10% to about 25% by volume. In one embodiment, ethanol is present in the solvent at about 20% to about 30% by volume. In another embodiment, the pharmaceutical preparation contains a single solvent.

[0044] The concentration of the formoterol fumarate and aclidinium bromide in the finished pharmaceutical preparation depends on the desired therapeutic effects, and can be determined by a person of ordinary skill in the art. In an embodiment, the concentration of formoterol fumarate in the formulation is between about 0.6mg/100ml and about iOmg/lOOml, more specifically between about 0.6rag/100ral and about l 2mg/!0Qml. In an embodiment, the concentration of aciidinium bromide is between about lOmg/lOOmi and about 60mg/i00mL more specifically between about 20mg/100ml and about 40nig/100nil.

[0045] In an embodiment of the formulation according to the invention, the pH of the formulation is between about 2.8 and about 6 0.

[0046] In formulations according to the invention, if desired, edetic acid (EDTA) or one of the known salts thereof, disodium edetate or edetate disodium dihydrate, may be added as a stabilizer or complexing agent. In an embodiment, the formulation of the invention contains edetic acid and/or a salt or salts thereof. Other comparable stabilizers or complexing agents can be used in the present invention. Such other stabilizers or complexing agents include, for example, citric acid, edetate disodium, and edetate disodium dihydrate. In the present invention, complexing agents are molecules which are capable of entering into complex bonds. In an embodiment, complexing agents have the effect of complexing cations.

[0047] In an embodiment, the concentration of the stabilizer or complexing agents is about 2 mg/!GOml to about 22 mg/! 00 mi. In an embodiment, the concentration of the stabilizer or complexing agents is about 5 mg/100ml to about 16.5mg/100 ml. In one embodiment, the concentration of edetate disodium dihydrate is about 2mg/100ml to about 5 mg/100 ml. More specifically, in an embodiment, the concentration range is from about 11 mg/100 ml to less than about 20 mg/100 ml. In another embodiment, the concentration of edetate disodium dihydrate is about 11 mg/ 100 ml.

[0048] In an embodim ent of the invention, formotero! fumarate and aciidinium bromide are present in solution in the pharmaceutical formulation. In another embodiment, all the ingredients of the formulation are present in solution.

[0049] In addition to ethanol, other co-solvents may be added to the formulation according to the invention. In an embodiment, other co-solvents are those which contain hydroxyl groups or other polar groups, such as alcohols, isopropyl alcohol, propylene glycol, polyethylene glycol, polypropylene glycol, glycerol, and polyoxyethylene alcohols. In an embodiment, the pharmaceutical formulation contains only water and ethanol as solvents, with no additional co solvents.

[0050] In the present invention, additives include any pharmacologically acceptable and/or therapeutically useful substance that is not an active substance but that can be formulated together with the active substances in a pharmacologically suitable solvent, in order to improve the qualities of the pharmaceutical formulation. In an embodiment, the additives have no pharmacological effects or no appreciable or at least no undesirable pharmacological effects in the context of the desired therapy. The additives include, for example, other stabilizers, complexing agents, antioxidants, surfactants, and/or preservatives which prolong the shelf life of the finished pharmaceutical formulation, vitamins and/or other additives known in the art. In an embodiment, the pharmaceutical formulation contains a preservative and no other additives.

[0051] In an embodiment, the formulations according to the invention include suitable surfactants, which may function as solubilizing agents. The solubilizing agents include pharmacologically acceptable substances. In an embodiment, the solubilizing agents are selected from surfactants such as, for example, tw'een-80, poloxamer, polyoxyethylated castor oil, polyethylene glycol, solutol HS 15, and polyvinylpyrrolidone. In one embodiment, the surfactant concentration is less than about 10 mg/100 ml, more particularly from about 1 mg/100 ml to less than about 10 mg/100 ml.

[0052] Suitable preservatives can be added to protect the formulation from contamination with pathogenic bacteria. Preservatives comprise, for example, benzalkonium chloride or benzoic acid or sodium benzoate. In an embodiment, the pharmaceutical formulation contains only benzalkonium chloride as a preservative. In an embodiment, the preservative is present in an amount of about lOmg/IOOml to about 30mg/100ml. In another embodiment, benzalkonium chloride is present in an amount of about 1 Omg/100ml to about 20mg/100mi

[0053] To produce the propellant-free aerosols according to the invention, the

pharmaceutical formulations containing formoterol fumarate and aclidinium bromide according to the invention may be used in an inhaler of the kind described hereinbefore.

[0054] A further developed embodiment of the preferred inhaler or atomizer is disclosed in US20190030268, which is incorporated by reference. This soft mist nebulizer can be used to produce the inhalable aerosols according to the invention.

[0055] The inhalation device can be carried anywhere by a patient, having a cylindrical shape and convenient size of less than about 8cm to about 18cm long, and about 2.5cm to about 5cm wide. The nebulizer sprays a defined volume of the pharmaceutical formulation out through small nozzles at high pressures, so as to produce inhalable aerosols.

[0056] FIG. 1 shows a longitudinal section through the atomizer comprising a block function and a counter in the stressed state. In an embodiment, the inhalation device comprises an atomizer 1, a fluid 2, a vessel 3, a fluid compartment 4, a pressure generator 5, a holder 6, a drive spring 7, a delivering tube 9, a non-return valve 10, pressure room 11, a nozzle 12, a mouthpiece 13, an aerosol 14, an air inlet 15, an upper shell 16, and an inside part 17.

[0057] The inhalation atomizer 1 comprising a block function and a counter described above for spraying a medicament fluid 2, such as a pharmaceutical formulation of the invention, is demonstrated in FIG. I in the stressed state. The atomizer 1 described above is a propellant-free portable inhaler.

[0058] For the typical atomizer 1 described above, an aerosol 14 that can be inhaled by a patient is generated through the atomization of the fluid 2, which in an embodiment, is a pharmaceutical formulation of the invention. The pharmaceutical formulation is typically administered at least once a day, more specifically multiple times a day, preferred at predestined time gaps, according to how seriously the illness affects the patient.

[0059] In an embodiment, the atomizer 1 described above has a substitutable and insertable vessel 3, which contains a medicament fluid 2. Therefore, a reservoir for holding the fluid 2 is formed in the vessel 3. Specifically, the medicament fluid 2 is located in the fluid compartment 4 formed by a collapsible bag in the vessel 3.

[0060] In an embodiment, the amount of fluid 2 for the inhalation atomizer 1 described above can provide an adequate amount for a patient, such as up to about 200 doses. In an embodiment, vessel 3 has a volume of about 2 ml to about 10 ml. A pressure generator 5 in the atomizer 1 is used to deliver and atomize the fluid 2, specifically in a predestined dosage amount. The fluid 2 is released and sprayed in individual doses, such as from about 5 to about 30 microliters.

[0061] In an embodiment, the atomizer 1 described above may have a pressure generator 5 and a holder 6, a drive spring 7, a delivering tube 9, a non-return valve 10, a pressure roo 11, and a nozzle 12 in the area of a mouthpiece 13. The vessel 3 is latched by the holder 6 in the atomizer 1 so that the delivering tube 9 is plunged into the vessel 3. The vessel 3 may be separated from the atomizer 1 for substitution.

[0062] In an embodiment, when drive spring 7 is stressed in axial direction, the delivering tube 9 and the vessel 3 along with the holder 6 will be shifted downwards. Then the fluid 2 will be sucked into the pressure room 11 through delivering tube 9 and the non-return valve 10.

[0063] In an embodiment, after releasing the holder 6, the stress is eased. During this process, the delivering tube 9 and closed non-return valve 10 are shifted back upward by releasing the drive spring 7 Consequently, the fluid 2 is under pressure in the pressure room 1 1. Then the fluid 2 is pushed through the nozzle 12 and atomized into an aerosol 14 by the pressure. A patient may inhale the aerosol 14 through the mouthpiece 13, while the air is sucked into the mouthpiece 13 through air inlets 15.

[0064] In an embodiment, the inhalation atomizer 1 described above has an upper shell 16 and an inside part 17, which may be rotated relative to the upper shell 16. A lower shell 18 is manually operable to attach onto the inside part 17. The lower shell 18 may be separated from the atomizer 1 so that the vessel 3 may be substituted and inserted.

[0065] In an embodiment, the inhalation atomizer 1 described above may have a lower shell 18, which carries the inside part 17, and which is rotatable relative to the upper shell 16. As a result of rotation and engagement between the upper unit 17 and the holder 6, through a gear 20, the holder 6 is axially moved the counter to the force of the drive spring 7 and the drive spring 7 is stressed.

[0066] In an embodiment in the stressed state, the vessel 3 is shifted downwards and reaches a final position, which is demonstrated in FIG. 1. The drive spring 7 is stressed under this final position. Then the holder 6 is clasped. The vessel 3 and the delivering tube 9 are prevented from moving upwards so that the drive spring 7 is stopped from easing.

[0067] In an embodiment, the atomizing process occurs after releasing the holder 6 The vessel 3, the delivering tube 9, and the holder 6 are shifted back by the drive spring 7 to the beginning position. This shifting is referred to as major shifting. While the major shifting occurs, the non-return valve 10 is closed and the fluid 2 is under the pressure in the pressure room 11 by the delivering tube 9, and then the fluid 2 is pushed out and atomized by the pressure.

[0068] In an embodiment, the inhalation atomizer 1 described above may have a clamping function. During the clamping, the vessel 3 performs a lifting shift for the withdrawal of the fluid 2 during the atomizing process. The gear 20 has sliding surfaces 21 on the upper shell 16 and/or on the holder 6, which may make holder 6 move axially when the holder 6 is rotated relative to the upper shell 16.

[0069] In an embodiment, the holder 6 is not blocked for too long and can carry on the major shifting. The fluid 2 is pushed out and atomized.

[0070] In an embodiment, when the holder 6 is in the clamping position, the sliding surfaces 21 move out of engagement. Then the gear 20 releases the holder 6 for the opposite axial shift.

[0071] In an embodiment, the atomizer 1 includes a counter element shown in FIG. 2. The counter element has a worm 24 and a counter ring 26. In an embodiment, the counter ring 26 is circular and has a dentate part at the bottom. The worm 24 has upper and lower end gears. The upper end gear contacts with the upper shell 16. The upper shell 16 has inside bulge 25. When the atomizer 1 is employed, the upper shell 16 rotates; and when the bulge 25 passes through the upper end gear of the worm 24, the worm 24 is driven to rotate. The rotation of the worm 24 drives the rotation of the counter ring 26 through the lower end gear. This results in the counting effect.

[0072] In an embodiment, the locking mechanism is realized mainly by two protrusions. Protrusion A is located on the outer wall of the lower unit of the inside part. Protrusion B is located on the inner wall of counter. The lower unit of the inside part is nested in the counter.

The counter can rotate relative to the lower unit of the inside part. Because of the rotation of the counter, the number displayed on the counter can change as the actuation number increases, and can be observed by the patient. After each actuation, the number displayed on the counter changes. Once the predetermined number of actuations is achieved, Protrusion A and Protrusion B will encounter each other and the counter will be prevented from further rotation. This blocks the atomizer, stopping it from further use. The number of actuations of the device can be counted by the counter.

[0073] The nebulizer described above is suitable for nebulizing the pharmaceutical preparations according to the invention to form an aerosol suitable for inhalation. Nevertheless, the formulation according to the invention can also be nebulized using other inhalers apart from those described above, such as ultrasonic vibrating mesh nebulizers and compressed air nebulizers.

EXAMPLES

[0074] Materials and Reagents:

Ethanol is commercially available and may be purchased from Nanjing reagent Co., Ltd. 50 % benzalkonium chloride is commercially available and may be purchased from Spectrum

Pharmaceuticals Inc. Formoterol fumarate is also commercially available and may be purchased from Hubei Chengdeli Chemical Tech Co., Ltd. L delate disodium dihydrate is also

commercially available and may be purchased from Nanjing reagent Co., Ltd.

Example 1

[0075] The Synthesis of Aclidinium Bromide:

(R)-quinuclidin-3-yl 2 -hydroxy-2, 2-di(thiophen-2-yl) acetate (10 g, 28.7 mmol) and (3- bromopropoxy) benzene (12.3 g, 57.4 mmol) were added to acetonitrile (100 rnL). The reaction mixture was heated to 80-90 °C and stirred for 8 hours, and then a white solid was formed. The mixture was cooled to 20-25°C, and the solid was filtered and washed with ice-cold acetonitrile (10 mL), repeated three times for filtering and washing; and then dried under vacuum at 50 °C to give white solid (!5.4g 27.4 mmol). The yield of aclidinium bromide was 95 %, and the HPLC purity was 99.8 %.

Example 2

j0076 j The preparation of sample 1, sample 2 and sample 3 inhalation solutions with different levels of edetate disodium dihydrate:

The ingredients are listed in table 1. 50% benzalkonium chloride according to table 1 , was dissolved in purified water for three times, and then transferred into a 100 ml volumetric flask. Edetate disodium di hydrate and anhydrous citric acid according to table 1 were added to the solution, and sonicated until completely dissolved; after that, formoterol fumarate and aclidinium bromide according to table 1 were added to the solution, and sonicated until completely dissolved. Edetate disodium dihydrate according to table 1 was added into the solution, and then sonicated until completely dissolved. Finally, the flask was made to volume with purified water, and adjusted pH to 3 0 with IN HC1. The sample 1, sample 2 and sample 3 solutions remained essentially clear. The results are shown in table 2.

Table 1 Ingredient contents of sample 1, sample 2 and sample 3 of inhaiable formulations

Table 2 Tested results of sample 1 , sample 2, and sample 3 of inflatable formulations

Example 3

[0077] The preparation of sample 4, sample 5, sample 6, sample 7 and sample 8 inhalation solutions with different pH values:

The ingredients are listed in table 3. 50% Benzaikonium chloride according to table 3, was dissolved in purified water for three times, and then transferred into a 100 ml volumetric flask. Edetate disodium dihydrate and anhydrous citric acid according to table 3 were added to the solution, and sonicated until completely dissolved; after that, formoterol fumarate and aclidinium bromide according to table 3 were added to the solution, and sonicated until completely dissolved. Finally, the flask was made to volume with purified water, and adjusted pH to objective values with IN HC1. The sample 4-8 solutions remained essentially clear. The results are shown in table 4.

Table 3 Ingredient contents of sample 4-8 of inhalable formulations

Table 4 The results of sample 4-8 of inhalable formulations Example 4

[0078] The preparation of sample 9, sample 10, sample 11 and sample 12 inhalation solutions;

The ingredients are listed in table 5. 50% benzalkonium chloride according to table 5, was dissolved in purified water for three times, and then transferred into a 100 ml volumetric flask. Edetate disodium dihydrate and anhydrous citric acid according to table 5 were added to the solution, and sonicated until completely dissolved; after that, formotero! fumarate and aclidinium bromide according to table 5 were added to the solution, and sonicated until completely dissolved. Edetate disodium dihydrate according to table 5 was added into the solution, and then sonicated until completely dissolved. Finally, the flask was made to volume with purified water, and adjusted pH to 3.0 with 1N HC1. The sample 9, sample 10, sample 11 and sample 12 solutions remained essentially clear. The results are shown in table 6

Table 5 Ingredient contents of sample 9-12 of inhalable formulations

Table 6 The results of sample 9-12 of inhalable formulations

Example 5

[0079] The preparation of sample 13, sample 14 and sample 15 inhalation solutions:

The ingredients are listed in table 7. 50% benzalkonium chloride according to table 7, was dissolved in purified water for three times, and then transferred into a 100 ml volumetric flask. Edetate disodium dihydrate and anhydrous citri c acid according to table 7 were added to the solution, and sonicated until completely dissolved; after that, formoterol fumarate and aclidinium bromide according to table 7 were added to the solution, and sonicated until completely dissolved. Edetate di sodium dihydrate according to table 7 was added into the solution, and then sonicated until completely dissolved. Finally, the flask was made to volume with purified water, and adjusted pH to 3.0 with IN HC1. The sample 13, sample 14 and sample 15 solutions remained essentially clear. The results are shown in table 8.

Table 7 Ingredient contents of sample 13-15 of inhalable formulations

Table 8 The results of sample 13, sample 14, and sample 15 of inhalabie formulations Example 6

[0080] The preparation of sample 16, sample 17 and sample 18 inhalation solutions:

The ingredients are listed in table 9. 50% benzalkonium chloride according to table 9, was dissolved in purified water for three times, and then transferred into a 100 ml volumetric flask. Edetate disodium dihydrate and anhydrous citri c acid according to table 9 were added to the solution, and sonicated until completely dissolved; after that, formoterol fumarate and aclidinium bromide according to table 9 were added to the solution, and sonicated until completely dissolved. Edetate di sodium dihydrate according to table 9 rvas added into the solution, and then sonicated until completely dissolved. Finally, the flask was made to volume with purified water, and adjusted pH to 3.0 with IN HC1. The sample 16, sample 17 and sample 18 solutions remained essentially clear. The results are shown in table 10.

Table 9 Ingredient contents of sample 16, sample 17 and sample 18 of inhalable formulations

Table 10 The results of sample 16, sample 17 and sample 18 of inhalable formulations

Example 7

[0081] Sample 13, sample 14 and sample 15 were sprayed by soft mist inhaler, ultrasonic vibrating mesh nebulizer, and compressed air nebulizer, respectively. Malvern Spraytec

(STP5313) was used to measure the particle size of the droplets. As shown in table 11, the results indicated that the D50 of sample 13, sample 14 and sample 15 were less than 10 pm, and the particle size distribution from the soft mist inhaler 'as more uniform.

Table 11 Particle size distribution by using different inhalers or nebulizers

Example 8

[0082] Aerodynamic Particle Size Distribution:

Sample 14 was sprayed by a soft mist inhaler. Aerodynamic particle size distribution of droplets of sample 14 was measured on a Next Generation Impact or (NGI). Next Generation Impactor operated at a flow rate of 30 L/rnin was used for determination of particle size distribution. For each of the impactor experiments, the impactor collection stages were coated with a silicone oil. The particle size distribution is expressed in terms of mass median aerodynamic diameter (MMAD) and Geometric Standard Deviation (GSD). The results showed that MMAD of formoterol fumarate and aclidinium bromide were less than 10 pm, The GSD of fomioterol fumarate and aclidinium bromide were less than 5% (Table 12)

Table 12 Aerodynamic particle size distribution

[0083] While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. For example, the present invention is not limited to the physical arrangements or dimensions illustrated or described. Nor is the present invention limited to any particular design or materials of construction. As such, the breadth and scope of the present invention should not be limited to any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents.