the compositions of this invention contain a cai and a polyethoxylated derivative of castor oil . the compositions are efficacious in treating and controlling glaucoma and ocular hypertension . in addition , the compositions are surprisingly comfortable and stable and the efficacy of the composition &# 39 ; s preservative is maintained . the compositions contain a cai , such as those disclosed in u . s . pat . nos . 5 , 153 , 192 ; 5 , 240 , 923 ; 5 , 378 , 703 ; and 4 , 797 , 413 , the contents of which are incorporated by reference . the compositions also contain a polyethoxylated derivative of castor oil . these derivatives are formed by the ethoxylation of castor oil with ethylene oxide . castor oil is generally composed of about 87 % ricinoleic acid , 7 % oleic acid , 3 % linoleic acid , 2 % palmitic acid , and 1 % stearic acid . the reaction of varying molar ratios of ethylene oxide with castor oil yields different polyethoxylated castor oil derivatives . the derivatives of the present invention include products resulting from the reaction of from 2 - 200 moles of ethylene oxide per one mole of castor oil . the derivatives can also be hydrogenated . the most preferred derivative is known as polyoxyl 35 castor oil , also known as cremophor el ( available from basf corp ., parsippany , n . j .). the compositions can also include ophthalmologically acceptable preservatives , viscosity enhancers , penetration enhancers , buffers , sodium chloride , mannitol , and water to form aqueous , sterile ophthalmic suspensions or solutions . furthermore , the compositions may contain a thickener such as cellulosics ( e . g . hydroxymethylcellulose , hydroxyethylcellulose , hydroxypropylmethylcellulose , methylcellulose ), polyvinylpyrrolidone , carbomers or the like to improve the retention of the medicament in the conjunctival sac . the cai compositions of the present invention are preferably formulated as topical ophthalmic suspensions or solutions , with a ph of about 4 . 0 - 8 . 0 , preferably 4 . 0 - 6 . 0 for solutions and 6 . 0 - 8 . 0 for suspensions . the cais will normally be contained in these formulations at concentrations of 0 . 1 - 10 weight / volume percent ( wt / v %), but preferably about 0 . 25 - 5 . 0 wt / v %. the polyethoxylated ether derivative of castor oil is present at concentrations between 0 . 01 - 10 . 0 wt / v %, preferably 0 . 5 - 3 . 0 wt / v %. the formulations will also preferably contain a preservative , such as , benzalkonium chloride , at concentrations from 0 . 001 - 0 . 1 wt / v %. thus , for topical treatment of glaucoma and ocular hypertension , one to three drops of these formulations would be delivered to the surface of the eye one to four times a day according to the routine discretion of a skilled clinician . the preferred composition is set forth in example 3 . all compositions can be formulated according to the routine discretion of one skilled in the ophthalmic formulations art . ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 08 % cremophor el 1 . 5 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 08 % cremophor el 1 . 5 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 08 % cremophor el 1 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 08 % cremophor el 0 . 5 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 08 % cremophor el 0 . 25 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 0 . 324 % cremophor el 1 . 5 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 12 % cremophor el 1 . 5 % dibasic sodium phosphate 0 . 1 %( anhydrous ), uspmonobasic sodium phosphate 0 . 02 %( monohydrate ), uspmannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 2 . 24 % cremophor el 1 . 5 % dibasic sodium phosphate 0 . 1 %( anhydrous ), uspmonobasic sodium phosphate 0 . 02 %( monohydrate ), uspmannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 2 . 24 % cremophor el 1 . 5 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 1 . 12 % cremophor el 1 . 5 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 0 . 5 % cremophor el 1 . 0 % dibasic sodium phosphate 0 . 2 %( anhydrous ), uspmannitol 4 . 0 % disodium edta ( edetate disodium ) 0 . 1 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 7 . 4purified water qs 100 % ______________________________________ ______________________________________ concentrationingredient ( wt ./ v %) ______________________________________cai 0 . 4 % cremophor el 3 . 0 % sodium acetate ( trihydrate ) 0 . 1 % mannitol 4 . 1 % disodium edta ( edetate disodium ) 0 . 01 % benzalkonium chloride solution 0 . 01 % hydroxypropyl methylcellulose ( 2910 ) 0 . 8 %( e4m ) hydrochloric acid / sodium hydroxide ph 5 . 0purified water qs 100 % ______________________________________
the present invention is directed to topical ophthalmic formulations of carbonic anhydrase inhibitors and polyethoxylated derivatives of castor oil . methods for using the formulations for treating and controlling glaucoma and ocular hypertension are also disclosed .