N-[2-[5-[5-[[(2R,6S)-2,6-dimethyl-4-piperidyl]sulfonyl]-2-ethoxy-phenyl]-1-methyl-3-propyl-pyrazolo[4,3-d]pyrimidin-1-ium-5-ylium-7-yl]oxythiazol-5-yl]-N-methyl-nitrous amide