Diamide compounds having muscarinic receptor antagonist and Beta2 adrenergic receptor agonist activity

A pharmaceutical composition comprising an isotonic aqueous solution comprising a compound of formula I:

• wherein
• Y is a group of formula (a):
• Ar1nCH2pxCH2q (a)
• and Y is attached at the 3- or 4-position of the phenylene ring relative to the —CH2—(CR5R6)e— group;
• X is selected from —C(O)NH— and —NHC(O)—;
• Ar1 is selected from phen-1,3-ylene and phen-1,4-ylene, wherein the phenylene group is unsubstituted or substituted with 1 to 3 substituents selected independently from C1-3 alkyl, —O—(C1-3 alkyl) and halo;
• each R1 is selected independently from C1-3 alkyl, —O—(C1-3 alkyl), hydroxyl and halo;
• each R2 is selected independently from C1-3 alkyl, —O—(C1-3 alkyl) and halo;
• each R3 is selected independently from C1-3 alkyl;
• or two R3 groups are joined to form C1-3 alkylene, C2-3 alkenylene or oxiran-2,3-diyl;
• each R4 is selected independently from C1-3 alkyl, —O—(C1-3 alkyl) and halo;
• R5 is selected from hydrogen, methyl and ethyl;
• R6 is selected from hydrogen, methyl and ethyl;
• Ra is selected from C1-6 alkyl;
• a is 0, 1, 2 or 3;
• b is 0, 1, 2 or 3;
• c is 0, 1, 2, 3 or 4;
• d is 0, 1, 2 or 3;
• e is 0 or 1;
• n is 0 or 1;
• p is 0, 1, 2, 3, 4, 5 or 6;
• provided that when n is 0, p is 1, 2, 3, 4, 5 or 6;
• q is 0, 1, 2, 3, 4, 5 or 6;
• or a pharmaceutically acceptable salt thereof.