Disclosed is a compound of formula I, such as 1-{ 2-[{ 6-[({ 5-[{ 3-[({ [(2S)-1-{ 2-[(5R)-3-[3,5- bis(trifluoromethyl)benzoyl]-5-(4-fluorophenyl)-1,3-oxazolidin-5-yl]ethyl} -2,3-dihydrospiro[indene-1,4-piperidin]-2-yl]oxy} acetyl)(methyl)amino]propyl} (methyl)carbamoyl]-2-thienyl} methyl)amino]hexanoyl} (methyl)amino]ethyl} piperidin-4-yl biphenyl-2-ylcarbamate and 1-(2-{ [6-({ 6-[{ 3-[({ [(2S)-1-{ 2-[(5R)-3-[3,5-bis(trifluoromethyl)benzoyl]-5-(4-fluorophenyl)-1,3-oxazolidin-5-yl]ethyl} -2,3-dihydrospiro[indene-1,4-piperidin]-2-yl]oxy} acetyl)(methyl)amino]propyl} (methyl)carbamoyl]pyridin-3-yl} amino)hexanoyl](methyl)amino} ethyl)piperidin-4-yl biphenyl-2-ylcarbamate, which is useful for treating diseases or disorders mediated by a neurokinin NK1 receptor, NK2 receptor and a muscarine M3 receptor such as respiratory, allergic and neurological diseases.
