This guide is a navigation summary of Lexus L-SB-0045-12 Rev1, not a replacement for the copyrighted bulletin or the model-year repair manual. It applies only to the stated US-market 2010–2017 RX 450h condition: initial cold-soak rough running and/or one of P0300 through P0306.
Confirm the condition and codes, perform the complete applicable misfire diagnosis, and stop using this bulletin path if a concern is found in the mechanical engine, engine control, ignition or fuel-supply system. If those checks reveal no concern, inspect injector tips for debris using authorized procedures. Replace all six injectors only for a positive debris finding, then clear DTCs, start the engine and confirm the repair. A negative finding exits to normal diagnosis.