although , as noted above , local anaesthetics such as dyclonine and pramoxine have been used topically on the skin and locally on mucosal tissues of the mouth , larynx , trachea and esophagus and in urologic endoscopy , gynecology and proctology , the prior art has not recognized the utility of these compounds in anaesthetically effective concentrations in the form of pharmaceutically acceptable compositions for direct application to mucosal membranes of the sinuses to relieve headache and congestion , preferably in combination with an effective amount of a sympathomimetic amine decongestant . further , although the prior art teaches the local application of cocaine to sinusidal tissues , the use of this drug for this purpose is contraindicated because of its addictive properties and susceptibility to abuse as well as its toxicity . i have now discovered that compositions containing dyclonine or pramoxine as the active , non - addictive , rapidly absorbing , anaesthetic ingredient in a concentration from about 0 . 01 percent weight / weight to about 0 . 1 percent weight / weight , preferably in an amount from about 0 . 025 percent weight / weight to about 0 . 075 percent weight / weight , incorporated in a pharmaceutically acceptable vehicle , as the sole therapeutic ingredient or , preferably , in combination with a decongestant for example a sympathomimetic amine such as an arylalkylamine , imidazoline or cycloalkylamine in a concentration from about 0 . 1 percent weight / weight to about 1 . 0 percent weight / weight , preferably from about 0 . 25 percent to about 0 . 75 percent weight / weight are surprisingly effective in the treatment of sinus headache . sympathomimetic amine decongestants useful in the present invention may be selected from the group consisting of arylalkylamines such as phenylephrine , epinephrine , ephedrine , desoxyphedrine , phenylpropanolamine and tuaminoheptane ; the imidazolines such as naphazoline , oxymetazoline , tetrahydrozoline and xylometazoline ; and cyclo alkylamines such as propylhexadrine and mixtures thereof . although the precise mechanism of action of the novel compositions of this invention is not fully known , i believe that the rapid onset of action and quick relief of headache associated with sinusidal pain , particularly when accompanied by inflammation and / or congestion , following application of the novel compositions , is attributable to a synergistic coaction between the anaesthetic and decongestant components . when the mucosal tissues of the sinuses block the sinus openings by expansion , the resulting pressure causes headache pain . relief is obtained by local application of the anaesthetic and removal of the cause of the congestion . the quick and effective elimination of this duality of underlying causes is achievable when the anaesthetic / decongestant combination is applied directly to the affected area . the compositions of the present invention may be administered directly to the nasal sinuses in the form of a nasal spray , nasal gel , nose drops or insufflation . as noted above , the anaesthetic and decongestant components of the compositions of this invention are suitably formulated as pharmacologically acceptable acid addition salts . by the term &# 34 ; pharmacologically acceptable acid addition salts &# 34 ; is meant any non - toxic pharmaceutically suitable salt of a compound described above which has the desired pharmacologic properties in mammals . preparation of such salts is well known to those skilled in pharmaceutical science . pharmacologically acceptable acid addition salts of the above compounds include , but are not limited to , the hydrochloride , hydrobromide , hydroiodide , sulfate , bisulfate , nitrate , citrate , tartrate , bitartrate , lactate , phosphate , maleate , malate , fumarate , succinate , acetate and pamoate . suitable non - toxic pharmaceutically acceptable carriers for the anaesthetics and decongestants of this invention for the purpose of delivering the active components to the site of action will be apparent to those skilled in the art of pharmaceutical compounding . for this purpose reference is made to the text entitled ` remington &# 39 ; s pharmaceutical sciences `, 14th ed ., 1970 . obviously the choice of suitable carriers will depend on the exact nature of the particular nasal dosage form desired , that is to say , whether the drugs are to be formulated into a nasal solution , for use as a spray or as drops ; a nasal suspension ; nasal gel or an insufflation . preferred nasal dosage forms are nasal sprays and drops which contain a major amount of water , suitably purified . minor amounts of other ingredients such as ph adjusters , emulsifiers , flavoring agents such as menthol and eucalyptol , wetting agents such as thonzonium bromide ( the merck index , 10th ed ., p . 9221 ) and surfactants such as polysorbate ( ibid . p . 7458 ) may also be present . most preferably , the nasal composition is isotonic . i . e ., it has the same osmotic pressure as blood serum . as is well known in the pharmaceutical art , isotonicity is accomplished by the addition of suitable quantities of salts . sodium chloride is the preferred salt . examples of suitable preservatives for inclusion in the compositions of this invention are benzalkonium chloride , edetate disodium , sodium bisulfite , phenylmercuric acetate , cetylpyridinium chloride , thimerosal , chlorobutanol , cetyltrimethyl ammonium bromide , methylparaben , propylparaben and butylparaben . as buffers , suitable examples include dibasic sodium phosphate , monobasic sodium phosphate , citric acid , sodium citrate , acetic acid , sodium acetate , boric acid , sodium carbonate , sodium borate , hydrochloric acid and sodium hydroxide . examples of the preparation of typical nasal compositions containing the therapeutically active components of this invention are set forth below . it is to be understood that these examples are given by way of illustration only and are not to be construed as limiting the invention either in spirit or in scope , as many modifications both in materials and in methods will be apparent to those skilled in the art . ______________________________________example 1 % w / w______________________________________thonzonium bromide 0 . 05oxymetazoline hydrochloride 0 . 05dyclonine hydrochloride 0 . 50sodium phosphate , monobasic , crystal 1 . 10sodium phosphate , dibasic , anhydrous 0 . 30thimerosal nf 0 . 002methyl paraben usp 0 . 0065propyl paraben usp 0 . 0035menthol usp 0 . 10eucalyptol nf 0 . 02camphor usp 0 . 02ethyl alcohol usp 0 . 06cetylpyridinium chloride 0 . 05sodium chloride reagent 0 . 20polysorbate 80 0 . 50purified water q . s . 100 . 00______________________________________ oxymetazoline hydrochloride , dyclonine hydrochloride and cetylpyridinium chloride are dissolved in 95 ml of purified water at 25 °- 30 ° c . with mixing to form a clear solution . the menthol , camphor , eucalyptol and alcohol are separately mixed to form a eutectic mixture in which are dissolved with mixing methyl paraben and propyl paraben . polysorbate 80 is added and , after mixing , the resulting composition is added with stirring to the previously prepared aqueous solution of active ingredients , the transfer being aided with a small quantity of water . the monobasic and dibasic sodium phosphates , thimerosal and sodium chloride are dissolved therein , the resultant composition is brought to volume with purified water at 25 ° c . batch temperature and filtered thru a 0 . 22 mm filter . ______________________________________example 2 % w / w______________________________________thonzonium bromide 0 . 05dyclonine hydrochloride 0 . 50sodium phosphate , monobasic , crystal 1 . 10sodium phosphate , dibasic , anhydrous 0 . 30thimerosal nf 0 . 002methyl paraben usp 0 . 0065propyl paraben usp 0 . 0035menthol usp 0 . 1000eucalyptol nf 0 . 02camphor usp 0 . 02ethyl alcohol usp 0 . 06cetylpyridinium chloride nf 0 . 05sodium chloride reagent 0 . 20polysorbate 80 0 . 50purified water q . s . 100 . 00______________________________________ dyclonine hydrochloride and cetylpyridinium chloride are dissolved in 95 ml of water at a temperature of 25 °- 30 ° c . with mixing . separately , a eutectic mixture is formed with menthol , eucalyptol , camphor and alcohol in which are dissolved with mixing methyl paraben , propyl paraben and thonzonium bromide . polysorbate 80 is added thereto with mixing and the resultant composition is added to the previously prepared aqueous solution of dyclonine hydrochloride and cetylpyridinium chloride with the aid of a small quantity of water . to this are added and dissolved the monobasic and dibasic sodium phosphates , thiomerosal and sodium chloride . the mixture is brought up to volume with water at batch temperature and filtered through a 0 . 22 mm filter . ______________________________________example 3 % w / w______________________________________thonzonium bromide 0 . 05dyclonine hydrochloride 1 . 00sodium phosphate , monobasic , crystal 1 . 10sodium phosphate , dibasic , anhydrous 0 . 30thimerosal nf 0 . 002methyl paraben usp 0 . 0065propyl paraben usp 0 . 0035menthol usp 0 . 1000eucalyptol nf 0 . 02camphor usp 0 . 02ethyl alcohol usp 0 . 06cetylpyridinium chloride nf 0 . 05sodium chloride reagent 0 . 20polysorbate 80 0 . 50purified water q . s . 100 . 00______________________________________ dyclonine hydrochloride and cetylpyridinium chloride are dissolved in 95 ml of water at a temperature of 25 °- 30 ° c . with mixing . separately , a eutectic mixture is formed with menthol , eucalyptol , camphor and alcohol in which are dissolved with mixing methyl paraben , propyl paraben and thonzonium bromide . polysorbate 80 is added thereto with mixing and the resultant composition is added to the previously prepared aqueous solution of dyclonine hydrochloride and cetylpyridinium chloride with the aid of a small quantity of water . to this are added and dissolved the monobasic and dibasic sodium phosphates , thimerosal and sodium chloride . the mixture is brought to volume with water at batch temperature and filtered through a 0 . 22 mm filter . the present invention has been described generally and with respect to preferred embodiments . it will be clear to those skilled in the art that modifications and / or variations of the disclosed compositions can be made without departing from the scope of the invention set forth herein . the invention is defined by the claims which follow .
the present invention contemplates nasal compositions effective for relieving mammalian sinus headache associated with inflamed or congested turbinates , or both , accompanied by localized pain perceived on the septum , containing an anaesthetically effective amount of a non - addictive , rapidly absorbable anaesthetic component such anaesthetic being the sole active ingredient in the composition or being combined with a decongestant of the sympathomimetic amine class .