Is adding lidocaine to a unit dose syringe of 99mTc-sulfur colloid for lymphoscintigraphy exempt from USP <797>?

No, this is considered compounding under USP <797> . However, this addition can likely fall under the immediate-use exemption.

Similar to dilution with normal saline, addition of lidocaine, whether in a vial or in the syringe, is considered compounding under USP <797>. However, this can generally be performed under the immediate-use exemption. Remember that the key components of the immediate-use provisions are the avoidance of touch contamination and administration within 1 hour.