Note: Noxafil needs to be prepared using the solvent.

Do not mix Noxafil with milk, juice, or water.

When you use the solvent for the first time:

• Open the bottle and remove the safety seal. Use scissors if needed.
• Place the bottle adapter on top of the bottle with the small hole facing up.
• Push the bottle adapter all the way down.
• Once in place, the bottle adapter stays in the bottle.
• Put the cap back on the bottle.

Note: Put your child in a safe place. You will need both hands to prepare Noxafil. Wash your hands with soap and water before preparing Noxafil.

1 mixing cup (Using the tab on the mixing cup, pull open the lid.)

1 sachet of Noxafil powder

Solvent

1 blue syringe and 1 green syringe (Have 1 of each ready, but you may only use 1, depending on the dose.)

Scissors (not included with kit: use sharp household or kitchen scissors)

The Noxafil box has a mixing cup holder inside to help tilt the cup when you are measuring the dose.

Note before adding Noxafil:

Make sure you and your child are ready. If you do not use

Noxafil within 30 minutes, you will need to throw it away and start over.

• Take 1 sachet of Noxafil and shake the powder to the bottom of the sachet. (Figure 1)
• Cut open the sachet at the dotted line and add all of the powder to the mixing cup. Make sure the sachet is completely empty. (Figure 2)

• Shake the solvent well before each time you prepare Noxafil.

• Push the plunger of the blue syringe into the syringe barrel as far as it goes.
• Remove the cap from the bottle of solvent.
• Push the notched tip of the syringe into the bottle adapter.
• With the syringe attached to the bottle, turn the bottle and syringe upside down. With your other hand, pull back the plunger to draw the solvent back into the syringe.
• Stop when you get to the 9 mL line.
• Turn the bottle back over and remove the syringe to check your measurement.

• Hold the syringe with notched tip up. Tap it with your finger to move any air bubbles.
• Slowly push the plunger to make the air come out. (Figure 1)
• Re-check the measurement of the solvent in the syringe. If it is less than 9 mL, put the notched tip back into the solvent and pull the plunger back until you get to the 9 mL mark. (Figure 2)

• Add the 9 mL of solvent to the Noxafil powder in the mixing cup by pushing all the way down on the plunger.

• Snap the lid of the mixing cup shut.
• Shake the mixing cup really hard for 45 seconds to mix the Noxafil. (Figure 1)
• Check to make sure the powder is mixed.
  If it is not mixed, shake the mixing cup some more. Noxafil should look cloudy and free of clumps. (Figure 2)

• Use the dose amount in ‘mL’ prescribed by the doctor.

Note: The dose may change each time you go to the doctor, so make sure you have all the recent information. Be sure to go to all of your child’s doctor appointments so your child gets the right dose.

Note: Only use the syringes provided in the kit.

Choose the correct syringe for your child's dose:

For 1 mL to 3 mL Green

For 3 mL to 10 mL Blue

• Then find the mL mark on the syringe that matches your child's dose.

• Push the plunger into the dosing syringe as far as it goes. (Figure 1)
• Tilt the cup by hand or use the mixing cup holder inside the Noxafil box. (Figure 2)
• Put the notched tip of the dosing syringe into the lowest part of the cup with the Noxafil and pull back the plunger. (Figure 3)
• Stop when you get to the line showing the prescribed dose.

Note: You will not use all of the Noxafil. There will be some left over in the mixing cup.

• Hold the syringe with notched tip up. Tap it with your finger to move any air bubbles.
• Slowly push the plunger to make the air come out. (Figure 1)
• Re-check the measurement of Noxafil in the syringe. If it is less than the prescribed dose, put the notched tip back into the mixing cup with the Noxafil and pull the plunger back until you get to the right dose mark. (Figure 2)

• Gently place the syringe inside your child’s mouth so that the notched tip touches the inside of their cheek.
• Slowly push down on the plunger to give the dose of Noxafil. It is important that your child takes all of the dose (a little left in the syringe notched tip is ok).

Note:

• If your child vomits or spits out the whole dose within 15 minutes of taking Noxafil, a dose may be repeated once. Follow-up your doctor or pharmacist if this occurs.
• Only use the solvent from the kit. Do not mix Noxafil with milk, juice, or water.

Note: Syringes and mixing cups should be reused. Do not throw away syringes and mixing cups provided until all the Noxafil sachets are used. If syringes cannot be washed and reused, additional syringes are provided in pack 2.

• Pour the leftover Noxafil from the mixing cup into the household waste bin.
  Do not pour it into the sink.
• Pull the plungers out of any syringes you used.
• Hand wash the syringes, plungers, and mixing cup with warm water and washing-up liquid. Do not wash in the dishwasher.
• Rinse with water and air dry.
• Put everything in a clean, dry place.

• After you have used the last Noxafil sachet in this box, you will have leftover solvent in the bottle. Throw away the leftover solvent and all components of the kit.