Drug is usually given at night in case patient needs sedation for side effects. Solution may be injected into any suitable vein , although injection into tubing of a flowing IV infusion set is preferable to reduce possibility of severe local reactions from extravasation or high drug concentration. Complete injection within a few minutes.
Local therapy is used only when malignant cells are found in effusion.
Intracavitary injection is not recommended when fluid is chylous. Perform paracentesis to remove most of fluid from pleural or peritoneal cavity. Prepare solution and introduce directly through a thoracentesis needle for intrapleural or intrapericardial injection or introduce through a rubber catheter inserted into the trocar used for paracentesis or through a No. 18 needle inserted at another site for intraperitoneal injection. Inject drug slowly and frequently aspirate to ensure free flow of fluid. Give patient physical and x-ray examination to detect fluid reaccumulation.