JP2005281315A - Aqueous pharmacological composition - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To obtain an aqueous composition containing a medicine effective on the treatment of an abnormal physical state by the existence of the composition on the surface of a mucous membrane which covers a nasal cavity. <P>SOLUTION: This aqueous medicine composition capable of being sprayed in the nasal cavity of each individual person comprises the following ingredients: (A) solid medicine particles in a pharmacologically effective amount and (B) a precipitation-preventing agent at a dose effective for maintaining the uniform dispersion state of the particles in the composition and imparting a constant thixotropic property to the composition; and the medicine is an anti-inflammatory steroid agent selected from the group consisting of dexamethasone, prednisolone and triamcinolone acetonide. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

The present invention relates to aqueous pharmacological compositions. More particularly, the present invention relates to an aqueous composition containing a pharmaceutical agent that is effective in treating abnormal physical conditions by being present on the surface of the mucosa covering the nasal cavity.
The relevant field of the invention is first described in the context of treating specific forms of rhinitis, namely abnormal physical conditions including inflammation of the nasal mucosa. As described below, it should be understood that the present invention has a wide range of applications.

  It is estimated that 40 million Americans suffer from periodic and perennial allergic rhinitis. In addition, millions of individuals suffer from this condition worldwide. Symptoms of periodic and perennial allergic rhinitis include nasal itching, redness, runny nose, sneezing and eye hydration. Periodic allergic rhinitis is commonly known as “hay fever”. This is due to allergens present in the air at specific times of the year. Pollen in the spring of a year is an example of such an allergen. Perennial allergic rhinitis is caused by allergens present in the environment throughout the year. Examples of such allergens are dust mites, mushrooms, powdery mildew, and pet scales.

  It is known to treat such forms of rhinitis with medicaments such as steroidal anti-inflammatory agents. An example of a widely used steroidal anti-inflammatory agent is triamcinolone acetonide. Such drugs are commonly used by spraying the drug into the nasal passages of a human patient and depositing the drug on the surface of the mucosa that covers the nasal cavity. In this position, the drug exerts its pharmacological action in contact with body tissue and interacts with the steroid receptor.

  In order to achieve maximum effectiveness, a pharmacological composition containing a medicament of the above type needs to have a predetermined combination of properties. For example, the nature of the pharmacological composition containing the medicament should be such that the medicament is readily released to any part of the nasal cavity (target tissue) where it performs its pharmacological function. Furthermore, the medicament should maintain contact with the target tissue for a relatively long period of time. The longer the period in which the medicament is in contact with the target tissue, the greater the chance that the medicament will perform its function. In order to maintain contact with the target tissue, the medicament needs to be able to resist the efficacy in the nasal passage, which functions to remove particles from the nose. Such efficacy, referred to as “mucocillary clearance”, is very effective in removing particles from the nose quickly, for example within 10-30 minutes from the time the particles enter the nose. It is recognized.

Other desirable properties of this pharmacological composition are that it does not contain ingredients that cause discomfort to the user, has satisfactory stability and shelf life, and contains ingredients that appear to be harmful to the environment, such as ozone depleting substances. It is not included.
The present invention relates to a pharmacological composition, which is particularly effective in reducing abnormal physical conditions that can be treated by depositing the pharmacological composition on the mucosal surface covering the nasal passages. And a combination of various characteristics that are suitable for that purpose.

Reported Cases The following patents disclose pharmacological compositions containing various types of medicaments that function to treat abnormal physical conditions by being present on the mucosal surface of the nasal cavity. US Pat. Nos. 3,780,176, 3,809,294, 3,897,779, 4,405,598, 4,250,163, 4,294,829, 4,304,765, 4,407,792, U.S. Pat. Nos. 4,432,964, 4,443,440, 4,478,818 and 5,439,670.
In contrast to the compositions described in the above patents, the pharmacological compositions of the present invention are aqueous systems.

SUMMARY OF THE INVENTION According to the present invention, an aqueous pharmacological composition is provided, which can be sprayed into the nasal cavity of each individual, and the composition comprises (A) a pharmacologically effective amount. The solid particles of the medicament, wherein the medicament is effective in treating a bodily condition by being present on the mucosal surface of the nasal cavity, and (B) uniform dispersion of the particles in the composition An amount of a suspending agent effective to maintain the state and impart the following thixotropic properties to the composition: (i) a relatively high viscosity in the non-sheared state, and the composition is gel- (Ii) when the composition is formulated for spraying, when placed under the action of shear forces (shaking), the composition has a relatively low viscosity and is in a mist state. The composition is at a level such that it easily flows within the nasal passage and deposits on the mucosal surface of the nasal cavity, and (iii) When deposited on the mucosal surface, the viscosity of the composition is relatively high and is such that it is resistant to exclusion from the mucosal surface due to the inherent mucosal forces found in the nasal cavity. It is in.

In a preferred embodiment, the medicament comprises an anti-inflammatory steroid, most preferably triamcinolone acetonide. Similarly, in a preferred embodiment, the composition of the present invention is odorless and comprises a quaternary ammonium compound, preferably benzalkonium chloride, and a chelating agent, preferably disodium ethylenediaminetetraacetate (EDTA).
In another aspect of the invention, a method of applying solid particles of a medicament to the nasal mucosal surface is provided, the method spraying a unit dose of an aqueous pharmacological composition containing the medicament onto each of the nasal cavities. The dosage includes a pharmacologically effective amount of the medicament, the composition also includes a predetermined amount of a suspending agent, wherein the predetermined amount uniformly disperses the particles in the composition. It is an amount effective for maintaining the state and effective for imparting the following thixotropy to the composition. The thixotropic means that a pharmacologically effective amount of the medicament is at least on each of the mucosal surfaces of the anterior nasal region, anterior nasal sinus and maxillary sinus, and on the turbinates over the concha It is such that it is deposited on each mucosal surface, and that each portion of the amount is thixotropic so that it is maintained on each mucosal surface for at least about 1 hour.
In a preferred embodiment, the composition of the present invention is applied to the nasal cavity by nebulization using a pre-compression pump.

In yet another aspect of the present invention, there is provided a process for preparing an aqueous pharmacological composition, the composition comprising a medicament in the form of solid particles, a dispersant for wetting the particles and the particles substantially in the composition. And a suspending agent for imparting thixotropy to the composition, the method comprising: (A) producing an aqueous solution of the dispersant and Combine with the particles to prepare a suspension of the particles, (B) add the suspending agent to an acidic aqueous solution to form a thixotropic suspension, and (C) each of the suspensions Are combined by introducing one suspension into the bottom of the other suspension.
In one preferred embodiment, a suspension of solid particles of the medicament is introduced at the bottom of the thixotropic suspension.

  The present invention provides numerous and important advantages in the treatment of symptoms, including the application of pharmaceuticals to the mucosal surface covering the nasal cavity. As will be appreciated by reading the example portion of this application, the present invention provides a means for easily releasing the drug to many parts of the nasal cavity where the drug can exert its pharmacological action. give. According to the present invention, the medicament maintains contact with the target tissue for a relatively long period of time, for example, a period of at least about 1 hour and over 2 hours. Furthermore, the compositions of the present invention can be formulated to be free of ingredients that cause discomfort to the user, the compositions have satisfactory stability and, for example, 1-2 years shelf life characteristics, And it does not contain any components that are considered harmful to the environment.

Preferred embodiments of the present invention are listed below.
1. A method of applying solid particles of a medicament to the nasal mucosal surface comprising the step of spraying each dose of an aqueous pharmacological composition containing the medicament onto each of the nasal cavities, the dose being pharmacologically effective And the composition also includes a predetermined amount of a suspending agent, the predetermined amount being effective to maintain the particles in a uniform dispersion in the composition and the composition. In an amount effective to impart thixotropic properties to the product, wherein the thixotropic properties include a pharmacologically effective amount of the medicament at least in the anterior region of the nose, anterior nasal sinus and maxilla. Depositing on each mucosal surface of the sinus sinus and on each mucosal surface lying on the nasal turbinates overlying the turbinates and applying a pharmacologically effective amount of each portion for at least about 1 hour The above-mentioned method is characterized in that it is maintained on each mucosal surface. .
2. The method according to 1 above, wherein the medicament is an anti-inflammatory steroid.
3. The method of claim 2, wherein the anti-inflammatory steroid comprises triamcinolone acetonide and the dose comprises the triamcinolone acetonide in an amount effective to provide relief from allergic nasal inflammation. .
4. The method of claim 3, wherein the gel viscosity of the composition is in the range of about 50 to about 200 cp, and the shear viscosity of the composition is in the range of about 400 to about 1000 cp.
5. The method of claim 4 wherein the composition is odorless and comprises a quaternary ammonium compound and a chelating agent, and the suspending agent consists essentially of a mixture of microcrystalline cellulose and sodium carboxymethyl cellulose. .
6. The method of claim 5, wherein the quaternary ammonium compound consists essentially of benzalkonium chloride and the chelating agent consists essentially of EDTA.
7. The method of claim 1, wherein the composition is sprayed with a pre-compression pump.
8. Can be sprayed into the nasal cavity of each individual and comprises the following components: (A) a pharmacologically effective amount of solid drug particles, wherein the drug is present on the mucosal surface of the nasal cavity,
Effective in treating bodily conditions; and (B) an amount effective to maintain a uniform dispersion of the particles in the composition and to impart the following thixotropic properties to the composition: And (i) a relatively high viscosity in the non-shear state,
The composition is in a gel-like form, and (ii) when the composition is formulated for spraying, when placed under the action of shear forces (shaking), the viscosity of the composition is relatively At a level such that the composition in a low and mist state flows easily in the nasal passage and deposits on the mucosal surface of the nasal cavity, and (iii) The viscosity of the composition is relatively high and due to the inherent mucosal forces found in the nasal cavity,
An aqueous pharmacological composition, characterized in that it is at a level that is resistant to a tendency to exclude it from the mucosal surface.
9. The relatively low viscosity of the composition is in the range of about 50 to about 200 cp, and the relatively high viscosity of the composition is in the range of about 400 to about 1000 cp. Composition.
10. The composition according to 8 above, wherein the medicament is an anti-inflammatory steroid.
11. The composition according to 9 above, wherein the medicament is an anti-inflammatory steroid.
12. The composition of claim 10, wherein the steroid agent consists essentially of triamcinolone acetonide.
13. The composition of claim 11, wherein the steroid agent consists essentially of triamcinolone acetonide.
14. The composition according to 12 above, which is odorless and comprises a quaternary ammonium compound and a chelating agent.
15. The above 14 wherein the quaternary ammonium compound consists essentially of benzalkonium chloride, the chelating agent consists essentially of EDTA, and the suspending agent consists of a mixture of microcrystalline cellulose and sodium carboxymethyl cellulose. A composition according to 1.
16. The composition of claim 15, wherein the gel viscosity of the composition is from about 400 cp to about 800 cp, and the shear viscosity is from about 50 cp to about 200 cp.
17. A medicament in the form of solid particles, a dispersant for wetting the particles and a precipitate for maintaining the particles in a substantially uniform dispersion in the composition and imparting thixotropic properties to the composition A method for producing an aqueous pharmacological composition comprising an inhibitor comprising: (A) producing an aqueous solution of the dispersant and combining the solution with the solid particles to prepare a suspension of the particles. (B) adding the suspending agent to an acidic aqueous solution to produce a thixotropic suspension, and (C) each of the suspensions, one suspension of the other suspension A method as described above, comprising the steps of merging by introduction into the bottom.
18. The method of claim 17, wherein the suspension of solid particles is introduced at the bottom of the thixotropic suspension.
19. The particle suspension comprises particles of triamcinolone acetonide, a hydrophilic non-ionic surfactant and a quaternary ammonium antibacterial agent, wherein the thixotropic suspension comprises a chelator and an anti-osmotic pressure. 19. The method according to 18 above, comprising an agent.
20. The method of claim 19, wherein the antimicrobial agent consists essentially of benzalkonium chloride, the chelating agent consists essentially of EDTA, and the anti-osmotic agent consists essentially of dextrose.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a cross-sectional view of a pre-compression pump, which is in a quiescent state and can be used to apply the composition of the present invention to the nasal cavity.
FIG. 2 is a sectional view showing an operating state of the pump shown in FIG.

DETAILED DESCRIPTION OF THE INVENTION The aqueous composition of the present invention is a medicament and other pharmaceutically acceptable ingredients in solid particle form, at least compatible with the medicament and is harmless to the body under the conditions of use. It is a substance that avoids or minimizes tissue irritation. As will be understood from the following description, in the aqueous composition of the present invention, it is not necessary to use a propellant, which is an essential component of the aerosol product.
Water is present in large amounts in the composition. Typically, water comprises at least about 85% and more typically at least about 90% by weight of the composition.
The medicament used in the practice of the present invention is a medicament that enables treatment of an abnormal physical condition by being present on the mucosal surface of the nasal cavity. Examples of such medicaments are steroidal and non-steroidal anti-inflammatory agents, β-agonists and bronchodilators. Such medications provide relief from nasal symptoms caused by upper respiratory tract inflammation and allergic rhinitis.

  The medicaments that will be most widely used in the practice of the invention will be anti-inflammatory steroids such as clomethasone, dexamethasone, fluticasone, prednisolone and triamcinolone acetonide. Such steroidal compounds are relatively powerful drugs, but are highly effective when applied locally due to low systemic exposure. Triamcinolone acetonide is one of the preferred medicaments for use in the practice of the present invention.

  Pharmaceuticals such as triamcinolone acetonide are substantially water-insoluble and hydrophobic. For use in the present invention, such medicament is present in the composition as solid particles dispersed in its aqueous phase. The size of the particles is such that they can be uniformly dispersed in the composition. To that end, the size of the particles should not exceed about 50 microns. Preferably, the particles have an average particle size in the range of about 1μ to about 20μ.

  The medicament is present in the composition of the present invention at a pharmacologically effective concentration. Such concentrations will vary depending on the particular medicament or mixture thereof used, the condition to be treated and the nature of the individual to be treated. For guidance purposes, it is recommended that the medicament be included in the composition in the range of about 0.001 to about 2% by weight of the composition, preferably about 0.01 to about 0.2% by weight of the composition.

  The compositions of the present invention also contain pharmaceutically acceptable excipients that are effective to produce a thixotropic suspension of the solid particles of the medicament that make up the compositions of the present invention. This excipient can cause the pharmaceutical particles to enter the composition when not in use and upon spraying into the nasal cavity, and also when the composition is deposited on the mucosal surface of the nasal cavity. In an amount to maintain a dispersed state. The thixotropy of the composition at rest (unsheared) can be described as a gel in which the drug particles are substantially uniformly dispersed and suspended. . The quiescent viscosity of the composition is relatively high, for example in the range of about 400 to about 1000 cp. When the composition is placed under the action of a shear force, i.e., under the action of a force associated with agitation prior to spraying, the viscosity of the composition decreases (e.g., about 50 to about 200 cp); And flows easily through the spray device and is released from the device in a fine feather-like form, the feathers being at least the following part of the nose, ie the front region of the nose (anterior nasal cavity); Penetrates and deposits in the maxillary sinus; and the mucosa of the turbinates lying on the turbinates of the nasal cavity. Thus, this thixotropic composition contains a free-flowing liquid and, in the spray state, finds a predetermined mucosa and contains a fine mist deposited thereon. In the deposited and relatively unstrained state, the composition of the present invention exhibits an increase in viscosity and is presumed to be in its gel-like form, the gel form comprising pharmaceutical particles suspended therein. And is resistant to purification from the nasal passages due to the inherent mucosal forces present in the nasal cavity. Test results show that the deposited composition remains on the mucosal surface for a relatively long period of time, for example at least 1 hour and over 2 hours.

  For convenience, the viscosity of the composition at rest is referred to as “setting viscosity” and the viscosity of the shaken composition is referred to as “shear viscosity”. As mentioned above, the gel viscosity of the composition maintains the drug particles in a substantially uniform dispersion in the composition and keeps the composition on the mucosal surface for an extended period of time. On the mucosal surface, the composition is deposited in the nasal cavity. That is, the composition is resistant to excretion due to mucosal forces present in the nasal cavity. The shear viscosity of the composition is low enough that the composition flows freely through the pump orifice and collapses to form a fine mist.

  Appropriate values for the gel viscosity and the shear viscosity of the composition may be determined for a particular composition, also taking into account the particular means used to apply the composition to the nasal cavity. it can. As an example, a gel viscosity of about 400 to about 800 cp is recommended for compositions containing anti-inflammatory steroids such as triamcinolone acetonide. The recommended shear viscosity for such compositions is from about 50 to about 200 cp. Viscosity is measured using a Brookfield Synchro-Letric viscometer (Model LVT). The viscosity is measured at 20 ° C. The gel viscosity is measured after mixing for 30 seconds at 30 rpm. The shear viscosity is measured by mixing on a Burrell wrist-action shaker at full speed for 5 minutes, followed by mixing at 30 rpm for 30 seconds.

  Using any pharmaceutically acceptable substance capable of maintaining the substantially uniform dispersion of the pharmaceutical solid particles in the composition and imparting the predetermined thixotropy to the composition. it can. Such materials are called “suspending agents”. Examples of suspending agents include carboxymethylcellulose, veegum, tragacanth gum, bentonite, methylcellulose, and polyethylene glycol. A preferred suspending agent is a mixture of microcrystalline cellulose and carboxymethyl cellulose, the former preferably being present in large amounts, most preferably present in an amount of from about 85 to about 95% by weight, with the latter component being based on the mixture. About 5 to about 15% by weight.

The amount of the suspending agent included in the composition of the present invention depends on the specific pharmaceutical and its usage, the specific suspending agent used, the characteristics and amounts of the other components included in the composition, and the specific desired It will vary depending on the viscosity value. Generally speaking, the most widely used compositions will contain the suspending agent in an amount ranging from about 1 to about 5% by weight.
The pharmacological composition of the present invention preferably contains other components that impart predetermined characteristics to the composition.

  A composition comprising a hydrophobic medicament preferably comprises a pharmaceutically acceptable dispersant that wets the medicament particles to facilitate dispersion of the composition into the aqueous phase. The amount of the dispersant is sufficient to wet the hydrophobic drug particles in a short time, for example from about 5 to about 60 minutes, when the aqueous dispersion of particles is mixed in a known mixing device. Should be something. It is preferred to use an amount of the dispersant that will not cause foaming of the dispersion during mixing. It is recommended to include the dispersant in an amount ranging from about 0.001 to about 0.01% by weight of the composition.

  Any pharmaceutically acceptable dispersant that is effective in wetting the particles can be used. Examples of dispersants that can be used are fatty alcohols, esters, and ethers, such as those sold under the trade names Pluronic, Tergitol, Span, and Tween. is there. It is preferred to use a hydrophilic, non-ionic surfactant. Excellent results have been obtained using polyoxyethylene sorbitan monooleate, available under the trademark Polysorbate 80.

  It has been found that various types of medicaments that can be used in the compositions of the present invention tend to degrade in the presence of water as a result of oxidation. This can be prevented or prevented by using an antioxidant. Examples of pharmaceutically acceptable antioxidants that can be used in the compositions of the present invention include ascorbic acid, sodium ascorbate, sodium bisulfite, sodium thiosulfate, 8-hydroxyquinoline, and N-acetylcysteine. . It is recommended that the compositions of the present invention include the antioxidant in an amount ranging from about 0.001 to about 0.01% by weight.

  Also, for the purpose of enhancing stability, the composition of the present invention should be protected from microbial contamination and microbial growth. Examples of pharmaceutically acceptable antimicrobial agents that can be used in the compositions of the present invention include quaternary ammonium compounds such as benzalkonium chloride, benzethonium chloride, cetrimide, and cetylpyridinium chloride; mercury agents such as phenylmercuric nitrate. Including alcoholic drugs such as chlorobutanol, phenylethyl alcohol, and benzyl alcohol; antibiotic esters such as p-hydroxybenzoic acid; and other antibacterial agents such as chlorhexidine, chlorocresol, and polymyxin To do. It is recommended that the compositions of the present invention contain these antibacterial agents in an amount of about 0.001 to about 1% by weight.

As described above, according to one aspect of the present invention, there is provided a composition comprising a mixture of stabilizers that are odorless and that function as both an antioxidant and an antimicrobial agent. The mixture comprises a quaternary ammonium compound with antibacterial properties and a substance commonly known as a chelating agent. The use of the combination of the drug and the substance, such as triamcinolone acetonide, in the composition provides a highly stable composition, which is resistant to oxidative degradation and bacterial growth, etc. . In a preferred embodiment, the mixture comprises benzalkonium chloride and disodium ethylenediaminetetraacetate.
The odorless composition of the present invention will generally comprise from about 0.004 to about 0.02% by weight of the quaternary ammonium compound and from about 0.01 to about 0.5% by weight of a chelating agent. The use of the above mixture of compounds eliminates the need to include in the composition a substance that is considered an antioxidant.

  The composition of the present invention preferably comprises an isotonic agent that functions to prevent irritation of the nasal mucosa by the composition. Anhydrous dextose is the preferred isotonic agent. Examples of other pharmaceutically acceptable isotonic agents that can be used include sodium chloride, dextrose and calcium chloride. It is recommended that the compositions of the present invention contain up to about 5% by weight of the isotonic agent.

  The pH of the composition may vary depending on the particular medicament used and taking into account the biological tolerance and stability of the medicament. Typically, the pH of the composition is in the range of about 4.5 to about 7.5. The preferred pH for the composition containing triamcinolone acetonide is from about 4.5 to about 6, most preferably about 5. Examples of pharmaceutically acceptable substances that can be used to adjust the pH of the compositions of the present invention are hydrochloric acid and sodium hydroxide.

  The compositions of the present invention can be prepared by any suitable method. In a preferred embodiment, an aqueous suspension of pharmaceutical solid particles and a dispersant is prepared and combined with an aqueous suspension containing the suspending agent described above. The former is preferably prepared by adding the medicament to an aqueous solution of the dispersant and mixing well. The latter is prepared by making the water acidic (pH about 4.7 to about 5.3) before adding the suspending agent. In a particularly preferred embodiment, an aqueous solution of the quaternary compound (antibacterial agent) can be added to an aqueous pharmaceutical suspension to obtain other components (eg, isotonic agents, antioxidants or chelating agents). Add to this thixotropic suspension. Each of the above composition batches is combined after thorough mixing. A preferred means for merging these composition batches is to pump one of the batches, preferably the “medicine” batch, to the bottom of the other batch, eg the batch upwards through the other batch. It is to be introduced by transportation. The composition containing these combined batches is thoroughly mixed. The use of a preferred method of preparation provides an efficient and effective method for formulating a composition comprising solid particles of the medicament substantially uniformly dispersed in the composition, while preparing an aqueous pharmacological composition In addition, generally associated problems such as excessive foaming and non-uniformity of the particle dispersion are avoided.

  The amount of medicament applied to each nasal passage will vary depending on the particular medicament used, the nature of the condition to be treated and the characteristics of the individual to be treated. For guidance purposes, it is suggested that a unit dose applied to one of the nasal cavities is one containing about 200 to about 450 mcg or less of the medicament as described below. In frequent use of the composition, the user has determined that the daily dose required to effectively alleviate the condition can be reduced, for example, from about 100 to about 225 mcg of the medication per nasal cavity. it can.

  Utilization of the preferred embodiment of the composition of the present invention provides the advantage that the composition can be effectively administered once a day. For such once-daily administration, the amount of pharmaceutical agent such as triamcinolone acetonide applied per nostril is about 100 to about 220 mcg, more preferably about 100 to about 130 mcg. It is recommended. When the preferred embodiment of the composition is used frequently, the user can reduce the daily dosage for effective symptom relief, for example, from about 55 to about 110 mcg as the medicament per nasal cavity. You can decide to get.

  For applications related to children under the age of 12, the daily dose per nostril is about 100 to about 225 mcg of the medicament, and for preferred embodiments of the composition, the daily dose per nostril is It is recommended that the drug be about 50 to about 110 mcg. This amount can be reduced to a daily dosage of about 30 to about 55 mcg per nostril during frequent use of the medicament.

  A preferred means for applying the pharmacological composition of the invention to the nasal passage is the use of a pre-compression pump. A preferred precompression pump is model VP7, manufactured by Valois SA, France and marketed by Valois, USA (15 Valley Drive, Greenwich, Connecticut 06831).

  Referring to FIG. 1, the precompression pump 10 has a housing 12 and includes means such as threads 14 for connecting the pump 10 to a container of the composition. The housing 12 includes a cylindrical outer wall 16 defining a hollow tube 18, a housing inlet 20 connected to a dip tube 22, and a cylindrical shape disposed between the inlet 20 and the outer wall 16. And an internal wall 24 where the liquid enters the pump 10 from the container (not shown) via the dip tube.

A stem 26 extends from the top of the housing 12 and has a bottom portion 28 disposed within the housing hollow tube 18 that operatively fits the outer wall 16. A central tube 30 in the stem connects a stem inlet 32 to a stem outlet 34, through which the liquid is distributed to a sprayer to produce a spray body.
A clapper 36 is operatively disposed in the hollow tube 18 between the stem 26 and the inner wall 24. The clapper 36 includes a head portion 38 that fits into the stem inlet 32 and prevents fluid flow therethrough, a shoulder portion 40, and the housing inner wall 24 when the clapper 36 moves downward. And a bell-shaped bottom portion 42 designed to seal it. A spring 44 between the bottom of the housing 12 and the underside of the clapper head portion 38 biases the clapper head to fit and seal the test inlet 32.

  The pump 10 operates as follows. As shown in FIG. 1, at rest, the clapper head 38 seals the test inlet 32 to prevent liquid flow. The dosing chamber 46 is filled with the composition. The volume of the dosing chamber 46 is defined by the housing outer wall 16, the housing inner wall 24, the clapper 36, and the stem 26. The dose volume is adjusted by the dimensions of these various elements that define the dose chamber 46.

  The action of the user pressing the stem 26 with a finger causes the stem 26 and the clapper 36 to move downward. As seen in FIG. 2, the dosing chamber 46 is closed by the bottom portion 42 of the clapper mating with the housing inner wall 24 (FIG. 2 shows a side spray nozzle). However, this is given for illustrative purposes only, and it should be understood that other aspects such as top spray nozzles may be used). Application of further pressure results in an increase in hydraulic pressure within the composition, now isolated within the dosing chamber 46 relative to the pressure of the composition within the housing inner wall 24. Since the liquid is essentially incompressible, the increased hydraulic pressure of the composition in the dosing chamber 46 generates a net downward force on the clapper 36. Once this downward force exceeds an upward force on the clapper 36, such as a force from the spring 44, the clapper moves further upward away from the stem 26 to move the stem inlet 32. And allows the liquid composition to flow from the dosing chamber 46 to the stem outlet 34 to produce a nebulizer.

  When the user's finger action leaves the stem after this spraying, the spring 44 returns the clapper 36 to a mated and sealed condition with the inlet 32 and returns it to its rest position. . This movement creates a vacuum that draws the composition through the housing inlet 20 into the dosing chamber 46 for the next dose.

  Pre-compression pumps give a better spray body than those known from known pumps. During normal use, the precompression pump will release a complete dose of the composition. As previously described, the composition is sprayed until the hydraulic pressure of the composition reaches a “threshold” pressure in the pump sufficient to release the clapper 36 from the stem inlet 32. There will be no. Once the clapper 36 is released from the stem inlet 32, the hydraulic pressure by a user's finger pumps a predetermined amount of the composition to the stem inlet 32 for spraying. Thus, the nebulizer is not released before the threshold pressure is reached, and the full dose is released after the threshold pressure is reached. With known pumps, if sufficient force is not applied, or if it is not applied in an appropriate manner, less than a full dose may be released. When the precompression pump is used, it is very difficult to release less than the full dose when the pump is operating normally.

  Another advantage of the precompression pump is that the spraying of the spray body is guaranteed. When a known pump is used, the user cannot provide sufficient pressure to properly spray the spray body. However, the pre-compression pump does not release the composition until the threshold pressure is reached, which is devised to be sufficient for spraying.

  Furthermore, the precompression pump is less user dependent. Since the pump does not spray until the threshold pressure is reached, the pressing force and pressure application method provided by the user have a small effect on the spray.

Examples The following examples illustrate the invention.
Example 1
Preferred pharmacological compositions of the present invention are described below.

Ingredient wt% Amount, mg
Triamcinolone acetonide, USP finely pulverized 0.055 9.075
Topical grade (TAA)
Microcrystalline cellulose and sodium 2.0 330.00
Mixture with carboxymethylcellulose, NF
Polysorbate 80, NF surfactant 0.004 0.66
Disodium ethylenediaminetetraacetate, USP 0.05 8.25
Benzalkonium chloride (BzCl) solution, 50wt% 0.03 4.95
BzCl, NF
Dextrose (anhydrous), USP 5.0 825.00
Purified water, USP 92.86 15,322
Dilute hydrochloric acid, NF, * *
0.1N NaOH solution * *
Total weight 16.5 g
*: Used for pH adjustment.

This composition is prepared by mixing the individual components using a 2-container method. Large batches of the composition are prepared in the manner described below. A portion of 16.5 g is removed from the large batch and filled into spray bottles as also described below.
Approximately 500 kg of purified water is added to a stainless steel reaction gama equipped with a variable speed sweep mixer, a variable speed stirrer, and a constant speed disperser. About 0.4125 kg of disodium ethylenediaminetetraacetate (hereinafter “EDTA”) and 41.25 kg of dextrose are added to the water. After the ingredients are mixed for about 25 minutes, the disperser and stirrer are stopped and the sweep mixer is turned on. Approximately 0.6 kg of dilute hydrochloric acid (“HCl”) solution is added to the EDTA and dextrose solution. The disperser is restarted and then about 16.5 kg of a mixture of microcrystalline cellulose and sodium carboxymethyl cellulose is added to the acidified EDTA / dextrose solution. The resulting suspension is homogenized by continuing to mix for about 10 minutes. Next, all the mixers are stopped and the reaction mixture is scraped off. Using the sweep mixer and disperser, resume homogenization and run for about 15 minutes.

  Approximately 250 kg of purified water is added to a second stainless steel reaction gama equipped with a constant speed disperser and a constant speed mixer. The disperser and mixer are turned on and then about 0.033 kg of Polysorbate 80 (wetting agent) is added. After mixing for about 10 minutes, about 1 L of the solution is removed. While continuing to mix, approximately 0.45375 kg of triamcinolone acetonide TAA is added to the reaction cattle containing dissolved surfactant.

The “TAA” container is washed with the extracted surfactant solution, and the washing solution is added to the reaction cattail. The TAA suspension is homogenized using the disperser and mixer for about 25 minutes. The disperser is stopped and approximately 0.2475 kg of the benzalkonium chloride (BzCl) solution is added and dissolved in the resulting TAA dispersion. The “BzCl” container is washed with about 1 kg of purified water and the wash is added to the TAA dispersion. This “TAA” dispersion is transferred to the “thixotropic” portion of the composition by pumping it through the bottom outlet of the two reaction cattails of the TAA dispersion. The “TAA” reaction cattail is washed with about 10 kg of purified water and the wash is added to the composition comprising the combined TAA dispersion and the thixotropic moiety.

  The pH of the resulting composition is then measured. The target pH of the preferred embodiment of the present invention is in the range of 4.7 to 5.3. If necessary, the pH is most preferably 1) further diluted with purified water (20 parts water: 1 part diluted HCl, NF), diluted HCl, NF or 2) 0.1 N NaOH solution (4 g Adjust by adding either sodium hydroxide, NF dissolved in purified water and diluting to 1000 ml. Measure the amount of HCl or NaOH solution added and subtract an amount equal to this amount from 4.5 kg of purified water. After removing this subtracted portion, the remaining water is added to the composition and then homogenized for about 2 minutes using the disperser.

  The composition is then transferred to a reaction catama equipped with a constant speed mixer. Set the mixer at about 6 rpm and mix the composition thoroughly. This composition has a pH of about 4.8 and, in the resting state (unstrained state—no shear force applied), constitutes a gel-like suspension. The TAA particles are uniformly dispersed throughout the composition.

  A portion corresponding to 16.5 g of the composition is then added to a 20 ml round HDPE bottle. Before filling the bottle, approximately 0.2 u of filtered and pressurized air is blown into the bottle. The bottle is sealed with a metering pump. This metering pump is a VP7 / 100S from Valois with a dip tube, actuator, outer lid and safety clip.

Example 2
Another composition within the scope of the present invention is prepared utilizing the ingredients and methods described in Example 1. However, the following changes are made. In the first reaction cattail, EDTA, dextrose, and water are mixed for about 10 minutes, measured from the time the EDTA and dextrose are added to the water. About 0.53 kg HCl, NF is added to the EDTA and dextrose solution contained in the reaction cattail.

  Preparation of the “TAA” portion of the composition and feeding of the composition into the “thixotropic” portion is performed as described in Example 1. During the pH adjustment step after transport of the “TAA” portion to the “thixotropic” portion, the amount of HCl or NaOH solution added is measured and the equivalent is subtracted from 4.57 kg of purified water. After removal of the subtracted portion, the remaining water is added to the composition and then homogenized for about 2 minutes using the disperser. The pH of the composition is about 5. The TAA particles are uniformly dispersed throughout the composition. The bottle filling process is as described in Example 1.

In the following, examples are given on how the compositions of the invention can be used.
The compositions as described in Examples 1 and 2 can be inhaled nasally for effective treatment of allergic rhinitis symptoms. As described in Examples 1 and 2, each of the compositions is contained in a spray bottle equipped with a metering pump. The bottle contains about 16.5 g of the composition.
The composition can be injected into the patient by spraying one dose of the composition into each of the human patient's nasal cavities. For this one-dose injection, the pre-compression metering pump (Valois VP7 / 100S) is placed in the patient's nostril and then activated by the patient and sprayed into its nasal cavity Give the body. After the first dose, each operation of the pump injects about 100 mg of composition containing about 55 mcg TAA from the nasal actuator. Each bottle of the composition will give at least about 120 metered doses. For the exemplified composition, the recommended once daily dosing for adults and children over 12 years begins at about 220 mcg TAA, equivalent to two sprays in each nostril. . If the composition is used periodically, it should be considered to reduce the daily dose to about 110 mcg TAA (about 55 mcg per nostril).

  Compositions containing the formulations of Examples 1 and 2 were administered to 2 volunteer patients. After administration, the patient will be evaluated by positron emission tomography, 1) the length of time to take the maximum dose of the TAA medication to be injected into various areas of interest within the nasal cavity, and 2) The amount of TAA drug deposited on the area of interest over a 2 hour period was measured. For the purpose of such evaluation, the volume of the head region was divided into 104 separate regions of interest. Sites included within the region of interest are target sites such as: anterior sinus, anterior nasal sinus, maxillary nasal sinus, upper turbinate, and lower turbinate. The results of this evaluation indicate that the TAA medication is rapidly distributed to the nasal target area.

  For one of the volunteers, the maximum amount of the TAA medication that will be in contact with the concha region is about 65% of the total dose injected into the nose, and this is about Occurs after 45 seconds. About 46% of the total dose was in contact with the lower turbinate and about 19% of the total dose was in contact with the upper turbinate. The amount of the TAA medicament in contact with the turbinate tissue is a time course until a constant value of about 3.4-4% of the total dose is left in the turbinate tissue at the final time point. It decreased with. The maximum amount of the TAA drug in contact with the anterior sinus region was about 41%, which occurred at about 45 seconds after administration. The maximum amount of the TAA drug in contact with this anterior sinus region gradually decreased as a function of time and maintained a constant concentration of about 12% at 2 hours after administration. Based on this information, the anterior cavity sinus was considered the target tissue. This is because the deposited composition is maintained as a reservoir or backup source for the medicament. Slow posterior movement on the turbinate tissue through mucosal purification of the viscous composition suggests that TAA medication is continuously bathed in the target tissue, thus The effectiveness of the preferred once daily administration is illustrated. Interestingly, the drug appears to enter both the maxillary and anterior nasal sinuses. These data suggest that the drug particles are carried into the nasal sinus due to turbulent airflow during nasal inhalation. The maximum amount deposited was about 3.5% and 3.9% of the dose to the anterior and maxillary nasal sinuses, respectively, which occurred about 30 seconds after administration. These data show that the TAA medication is cleared from the anterior nasal sinus within 1 hour, and about 1% of the medication is still in the maxillary nasal sinus even after the 2 hour sampling period. It shows that it exists.

  For the other volunteer, the maximum amount of the drug in contact with the concha region is about 53% of the total dose injected into the nose, and the drug bound to the upper turbinate is about About 75% of the drug was 25% and bound to the lower turbinates. The maximum amount of the TAA drug in contact with the upper turbinate occurred about 25 seconds after administration, and about 3.5 minutes for the lower turbinate. These data suggest that the TAA drug migrates from the anterior sinus region to the concha region. At about 2 hours after administration, about 6-8% of the administered drug is still in contact with the concha region and the medication is gradually excluded from this target site.

  The maximum amount of the TAA medication in contact with the anterior sinus was about 55% of the total dose injected into the nose, which occurred at about 30 seconds after administration. The medication gradually left the nasal cavity, but about 22% of the dose was still retained after 2 hours. A small percentage of the administered dose of the TAA drug was in contact with the maxilla and anterior nasal sinus. The maximum amount was deposited within 30 seconds after administration and the amount was about 3.5% for the anterior nasal sinus and about 2% for the maxillary nasal sinus. These values were relatively constant, with amounts ranging from about 0.5% to 1% of the dose still remaining in the nasal sinus after 2 hours.

  This assessment also included measuring the percentage of the drug remaining on the target site at the 2 hour point after the TAA drug was administered to each of the patients. This percentage was determined by dividing the amount remaining in each region of interest by the total amount remaining in the 104 regions of interest. The results obtained from this evaluation show that over 85% of the dose is present on the target site, including the anterior sinus, anterior nasal sinus, maxillary nasal sinus, upper and lower turbinates. It shows that it is deposited directly.

  For the first volunteer mentioned above, these results indicated that at 2 hours after the administration of the TAA medication, approximately 47.9% of the total amount of the medication remained deposited in the anterior cavity. . At 2 hours after administration, the percentage of total drug deposited in the lower turbinate region (approximately 27.8%) combined with the amount deposited in the upper turbinate region (approximately 8.6%) This was approximately 36.4% of the remaining amount of the drug administered to the main target area. Over a two hour period, about 1.2% of the dose was deposited in the anterior nasal sinus, while about 3% of the dose was deposited in the maxillary nasal sinus. At 2 hours after administration of the medicament, the total percentage of the administered drug remaining at the target site is approximately 88.5% of the administered drug over the 2 hour sampling period. , Indicating that it was deposited directly on the target tissue.

For the second volunteer, the results indicated that approximately 22.2% of the administered drug remained deposited in the anterior cavity at 2 hours after drug administration. ing. About 23.5% of the dose was maintained deposited on the lower turbinates, and about 6.9% of the dose was maintained deposited on the upper turbinates. The total proportion of the drug maintained in the turbinate region in a deposited state was about 30.4% of the total injected drug. Values for the anterior and maxillary nasal sinuses were about 1.6% and about 1.4% of the amount of drug administered, respectively. The total percentage of the administered drug remaining on the target site 2 hours after the administration of the drug is approximately 85.6% of the administered drug during the 2 hour periodic sampling period. It shows that it was deposited directly on the target tissue.
It should be understood that the present invention provides an effective and improved means for reducing the patient's disturbed and abnormal physical condition.

FIG. 2 is a cross-sectional view of a pre-compression pump that is stationary and can be used to apply the composition of the present invention to the nasal cavity. It is sectional drawing which shows the operating state of the pump shown by FIG.

Claims (46)

An aqueous pharmaceutical composition comprising the following ingredients that can be sprayed into each individual's nasal cavity: (A) The drug is present on the mucosal surface of the nasal cavity and is effective in treating abnormal physical conditions Solid particles of a pharmacologically effective amount of the drug; and (B) maintaining a uniform dispersion of the particles in the composition and the composition having the following thixotropic properties: (i) the non-sheared state The viscosity of the composition is 400-1000 cp, the composition is in the form of a gel in which the particles are suspended; (ii) the effect of shear force (shaking) when the composition is formulated for spraying When placed underneath, the composition has a viscosity of 50-200 cp, and the composition in the mist state flows easily in the nasal passage and deposits on the mucosal surface of the nasal cavity. And (iii) when deposited on the mucosal surface, the composition has a viscosity of 400-1000 cp and is not visible in the nasal cavity. An amount of a suspending agent effective to impart a property that is resistant to a tendency to eliminate from the mucosal surface due to inherent mucosal forces; and the agent comprises dexamethasone, prednisolone, or The above pharmaceutical composition, which is an anti-inflammatory steroid selected from the group consisting of triamcinolone acetonide. The composition of claim 1 wherein the steroidal agent comprises triamcinolone acetonide. The composition according to claim 1 or 2, which is odorless and comprises a quaternary ammonium compound, a chelating agent and an anti-osmotic agent. 3. A composition according to claim 1 or claim 2 containing a dispersant effective to wet the drug particles. The quaternary ammonium compound is benzalkonium chloride, the chelating agent is EDTA, the anti-osmotic agent is dextrose, and the suspending agent comprises a mixture of microcrystalline cellulose and sodium carboxymethyl cellulose. The composition according to claim 3. At least 85% by weight water, the effective amount of the solid particulate drug is in the range of 0.001 to 2% by weight, and the effective amount of the suspending agent is in the range of 1 to 5% by weight. A composition according to any one of the ranges 2-4. The composition according to claim 4, wherein the dispersant is polysorbate 80 (TM). Contains no propellant, has a pH of 4.5 to 7.5, and the suspending agent contains a mixture of 85 to 95% by weight of microcrystalline cellulose and 5 to 15% by weight of carboxymethyl cellulose, based on the weight of the mixture The composition according to any one of claims 1, 2 and 4. The composition according to claim 8, comprising 0.004 to 0.02 wt% of the quaternary ammonium compound and 0.01 to 0.5 wt% of a chelating agent. An agent in the form of solid particles, a dispersant for wetting the particles, and a suspending agent for maintaining a uniform dispersion state of the particles in the composition and imparting thixotropic properties to the composition. A method for producing an aqueous pharmaceutical composition comprising: (A) producing an aqueous solution of the dispersant and combining the solution with the solid particles to prepare a suspension of the particles; An suspending agent is added to the acidic aqueous solution to produce a thixotropic suspension, and (C) each of the suspensions is introduced into the bottom of one suspension of the other. Wherein said agent is an anti-inflammatory steroid selected from the group consisting of dexamethasone, prednisolone, or triamcinolone acetonide. 11. A method according to claim 10, wherein the suspension of particles is introduced at the bottom of the thixotropic suspension. The suspension of particles comprises particles of triamcinolone acetonide, a hydrophilic nonionic surfactant and a quaternary ammonium antibacterial agent, and the thixotropic suspension comprises a chelator and an anti-osmotic agent; 12. A method according to claim 11. 13. The method of claim 12, wherein the antibacterial agent is benzalkonium chloride, the chelating agent is EDTA, and the anti-osmotic agent comprises dextrose. A pharmaceutical composition comprising a drug for treating rhinitis in each individual, wherein a predetermined amount of the composition containing solid particles of the drug and containing a pharmacologically effective amount of the drug is sprayed into the nasal cavity of each individual A composition that causes the agent to act on the mucosal surface of each individual's nasal cavity, and the composition also maintains a uniform dispersion of the particles in the composition, and the composition contains the following: Thixotropic: deposits a pharmaceutically effective amount of drug on each mucosal surface of the anterior nasal region, anterior and maxillary sinus, and on each mucosal surface overlying the turbinate And a pharmacologically effective amount of each part of the mucosal surface for at least one hour. And the drug is dexamethasone, prednisolone, or Or the said pharmaceutical composition which is an anti-inflammatory steroid agent selected from the group which consists of a triamcinolone acetonide. 15. The pharmaceutical composition according to claim 14, wherein the anti-inflammatory steroid is triamcinolone acetonide and comprises an effective amount of triamcinolone acetonide to reduce allergic rhinitis symptoms. 16. The pharmaceutical composition according to claim 15, wherein the gel viscosity of the composition is in the range of 400 to 1000 cp, and the shear viscosity of the composition is in the range of 50 to 200 cp. The pharmaceutical composition according to claim 16, wherein the composition is odorless and comprises a quaternary ammonium compound and a chelating agent, and the suspending agent comprises a mixture of microcrystalline cellulose and sodium carboxymethyl cellulose. . 18. A pharmaceutical composition according to claim 17, wherein the quaternary ammonium compound is benzalkonium chloride and the chelating agent consists of EDTA. The pharmaceutical composition according to any one of claims 14 to 18, wherein the composition is sprayed by a pre-compression pump. 15. The pharmaceutical composition according to claim 14, wherein the thixotropic property of the composition is as follows: (i) the viscosity of the composition in a non-shear state is 400 to 1000 cp, The particles are in a suspended gel form; (ii) when formulated for spraying, the composition has a viscosity of 50 to 50 when placed under the action of shear forces (shaking); 200 cp, such that the composition in a mist state flows easily in the nasal passage and deposits on the mucosal surface of the nasal cavity; and (iii) in the deposited state on the mucosal surface. The composition has a viscosity of 400-1000 cp and is resistant to the tendency to eliminate from the mucosal surface due to the inherent mucosal forces found in the nasal cavity. 20. A pharmaceutical composition according to any one of claims 14 to 19, comprising a dispersant effective to wet the drug particles. 22. Any of claims 14 to 21, comprising triamcinolone acetonide, a mixture of microcrystalline cellulose and sodium carboxymethyl cellulose, polysorbate 80 (TM), disodium ethylenediaminetetraacetate, benzalkonium chloride, dextrose, and purified water. A pharmaceutical composition according to claim 1. A pharmacologically effective amount of an agent, sprayed into each individual's nasal cavity, and an effective amount of the agent on the mucosal surface of the anterior nasal region, anterior nasal sinus and maxillary sinus, and instep 10. The method of claims 4-9, deposited on each mucosal surface overlying the turbinates, and wherein a pharmacologically effective amount of said drug is maintained on each of said mucosal surfaces for at least 1 hour. Pharmaceutical composition as described in any one. 24. The pharmaceutical composition according to any one of claims 14 to 23, comprising 200 to 450 mcg of drug administered to each nasal cavity. 25. The pharmaceutical composition according to claim 24, administered to each individual's nasal cavity once a day in an amount comprising 100-130 mcg of drug. 24. A pharmaceutical composition according to any one of claims 14 to 23, wherein at least 47% of the total drug is maintained deposited in the frontal sinus of each individual 2 hours after administration. 27. A device according to any one of claims 14 to 23 and 26, wherein at least 23% of the total drug is maintained deposited in the lower concha region of each individual 2 hours after administration. Pharmaceutical composition. 28. Any one of claims 14-23, 26 and 27, wherein at least 6% of the total drug is maintained deposited within each individual's upper concha region 2 hours after administration. The pharmaceutical composition according to item. Products including:
(A) The composition according to any one of claims 1 to 9,
(B) a container containing the composition; and (C) a pre-compression pump associated with the container that can spray the entire dose of the composition into the nostrils of each individual. 30. The product of claim 29, wherein the container comprises more than twice the full dose of the composition. 30. The product of claim 29, wherein the container comprises at least 120 times the full dose of the composition. 30. The product of claim 29, wherein the precompression pump is capable of spraying at least one complete dose of the composition, 100 mg, into each individual's nostril. An aqueous pharmaceutical composition that can be sprayed into the nasal cavity of each individual, is odorless, does not contain a propellant, and has a pH of 4.5 to 7.5, comprising: (A) at least 85% by weight of water ; (B) 0.001 to 2 wt% solid particles of triamcinolone acetonide drug; (C) containing a mixture of 85 to 95 wt% microcrystalline cellulose and 5 to 15 wt% carboxymethylcellulose, based on the weight of the mixture 1-5% by weight of a suspending agent, wherein said amount of suspending agent maintains a uniform dispersion of the particles in the composition and the composition has the following thixotropic properties: (i) The viscosity of the composition in the non-shear state is 400-1000 cp and the composition is in a gel form with the particles suspended therein; (ii) when the composition is sheared when formulated for spraying When placed under the action of (shaking), the viscosity of the composition is 50-200 cp; The composition in a strike state is such that it easily flows through the nasal passage and deposits on the mucosal surface of the nasal cavity; and (iii) the viscosity of the composition in the deposited state on the mucosal surface Is 400-1000 cp, and is an effective amount for imparting a property that is resistant to the tendency to eliminate from the mucosal surface by the inherent mucosal forces found in the nasal cavity; (D) a quaternary ammonium compound having an antibacterial property of 0.004 to 0.02% by weight; and (E) 0.01 to 0.5% by weight of a chelating agent. 34. The pharmaceutical composition according to claim 33, wherein the quaternary ammonium compound is benzalkonium chloride and the chelating agent consists of disodium ethylenediaminetetraacetate. 34. A pharmaceutical composition according to claim 33, comprising a dispersant effective to wet the drug particles. 36. The composition of claim 35, wherein the dispersant is polysorbate 80 (TM). 34. A pharmaceutical composition according to claim 33, comprising dextrose. 34. The pharmaceutical composition according to claim 33, wherein the solid particles of the drug have an average size of 1-20 [mu]. An aqueous pharmaceutical comprising a solid particulate drug of triamcinolone acetonide, a dispersant for wetting the drug, and a suspending agent for uniformly dispersing the particles in the composition and imparting thixotropic properties to the composition A product comprising the composition, wherein the product is prepared by a method comprising: (A) providing a suspension comprising the particles and the dispersant; (B) a thixotropic aqueous solution comprising the suspending agent. Prepare suspensions; and (C) mix each suspension by introducing one suspension into the bottom of the other suspension. 40. Product according to claim 39, wherein the suspension is mixed by introducing the suspension (A) into the bottom of the suspension (B). Suspension (A) is introduced to the bottom of suspension (B) by pumping suspension (A) to the bottom of suspension (B), thereby mixing the suspension 41. The product of claim 40. Before mixing the suspensions (A) and (B), an aqueous solution of a quaternary compound is added to the suspension (A), and an anti-osmotic agent and a chelating agent are added to the suspension (B). 40. The product of claim 39. A product comprising a solid particulate drug of triamcinolone acetonide and an aqueous pharmaceutical composition comprising a suspending agent for uniformly dispersing the particles in the composition and imparting thixotropic properties to the composition, The product produced by the method comprising: (A) providing a suspension containing the particles; (B) preparing a thixotropic aqueous suspension containing the suspending agent; and (C) one suspension. Each suspension is mixed by introducing a suspension into the bottom of the other suspension. 45. A product according to claim 43, wherein the suspension is mixed by introducing the suspension (A) into the bottom of the suspension (B). Suspension (A) is introduced to the bottom of suspension (B) by pumping suspension (A) to the bottom of suspension (B), thereby mixing the suspension 45. A product according to claim 44. Before mixing the suspensions (A) and (B), an aqueous solution of a quaternary compound is added to the suspension (A), and an anti-osmotic agent and a chelating agent are added to the suspension (B). 45. The product of claim 43.

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