2.1 Recommended Dose
The recommended dose is 5 g, suspended in 50 ml to 100 ml 0.9% Sodium Chloride Injection, USP
2.2 Preparation
Prepare the talc suspension using aseptic technique in an appropriate laminar flow hood as follows:
Step 1. Using a 16 gauge needle attached to a 60-ml LuerLok syringe, draw up 50 ml of 0.9 % Sodium Chloride injection, USP. Vent the talc bottle using a needle. Slowly inject the 50 ml of 0.9% Sodium Chloride Injection, USP into the bottle.
Step 2. Swirl the bottle to disperse the talc powder.
Step 3. Divide the contents of the bottle equally into two 60 ml LuerLok syringes, each attached with a 16 gauge needle, by withdrawing 25 ml of the suspension into each syringe with continuous swirling. Add 0.9% Sodium Chloride Injection, USP to a total volume of 50 ml in each syringe. Draw 10 ml of air into each syringe to the 60 ml mark to serve as a headspace for mixing prior to administration. Each syringe should contain 2.5 g of Sterile Talc Powder in 50 ml of 0.9% Sodium Chloride Injection, USP with an air headspace of 10 ml.
Step 4. Label the syringes with the talc concentration, the expiration date and time, the identity of the patient intended to receive the material, and the following statements:
“SHAKE SYRINGE WELL to resuspend before administration”
“FOR PLEURODESIS ONLY – not for intravenous administration”
Step 5. If not used immediately, store prepared suspension in refrigerator. Discard the prepared suspension if not used within 12 hours.
2.3 Administration
Prior to administration, continuously agitate the syringes to evenly redisperse the talc and avoid settlement. Immediately prior to administration, vent the 10 ml air headspace from each syringe. Administer the talc suspension through the chest tube according to standard procedures.