On higher mileage vehicles, an engine misfire may develop and/or the Check Engine Light may illuminate due to a failed ignition coil. It is not uncommon to replace all the coils when the first one fails in order to prevent return trips to the repair shop.
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Newest reported 2003 Lexus RX300 problems
Debris can get into the idle air control valve. This will restrict the air flow into the engine, causing idle speed and/or stalling when cold. The valve can be cleaned or replaced to correct this concern.