Syringe Driver Compatibility Chart
Two-drug combinations for use in syringe drivers via CSCI over 24 hours
Common three-drug combinations
| Diluent | |
|---|---|
| morphine + midazolam + levomepromazine | NaCl 0.9% |
| morphine + metoclopramide + midazolam | NaCl 0.9% |
| morphine + haloperidol + midazolam | NaCl 0.9% |
| morphine + hyoscine BUTYLbromide + haloperidol | NaCl 0.9% |
| oxycodone + midazolam + levomepromazine | NaCl 0.9% |
| oxycodone + metoclopramide + midazolam | NaCl 0.9% |
| oxycodone + haloperidol + midazolam | NaCl 0.9% |
| oxycodone + hyoscine BUTYLbromide + haloperidol | NaCl 0.9% |
| fentanyl + midazolam + levomepromazine | NaCl 0.9% |
| fentanyl + haloperidol + midazolam | NaCl 0.9% |
| Fentanyl + cyclizine + midazolam | WFI |
Notes
- Heat and light can cause medication combinations to become incompatible – keep below 25°C and protect from sun and UV light.
- Results from some included combinations are based on data collected in clinical settings via observing the medication combination at time of mixing and during infusion for any physical changes (discolouration, clouding or crystallisation). Hence, it is important that all CSCI syringes are observed for physical changes on compounding and at regular intervals during infusion.
- Although the combinations are based on physical and chemical compatibilities over 24 hours, many of the combinations have been observed to be physically compatible over a period of 72 hours when kept at 2-8°C. In NZ, a 72 hour expiry may be assigned to syringes compounded aseptically within pharmacies (NZ Pharmacy Service Standards 2010 – Aseptic Dispensing of Sterile Products). A watchful eye must be kept to ensure that the syringe remains colourless, clear and free from particulate matter during this extended period.
- Particular attention should be paid to those syringes containing high doses of any of the medications as they have the potential to become incompatible at higher concentrations.
- Please note that the hyoscine formulation stated in these charts is hyoscine BUTYLbromide (Buscopan®, Spazmol®) NOT hyoscine HYDRObromide, which although can be administered via CSCI is not included in this chart.
To download a colour or grey-scale version of the Syringe Driver Compatability Chart visit www.hospice.org.nz/syringe_driver_chart