Table 7: Subcutaneous Ketamine infusion

Diluent: 0.9% saline is the usual diluent for ketamine containing syringes

• The figures in these tables are NOT clinical doses to prescribe. They are the maximum amounts of each
  drug that can be mixed in the syringe and generally be considered physically stable for 24 hours.
• Most patients will require much lower doses. Refer to relevant guidelines to obtain the usual dose
  range to prescribe for each drug. Use minimum effective dose and review according to response.
• Mixing of drugs in this manner is unlicensed but is supported by clinical practice.
• Seek specialist advice from a clinical pharmacist if the doses needed are greater than those stated in the tables.
• Check the infusion after set up and in acute setting every 4 hours for any signs of precipitation, cloudiness,
  particles or colour change as external factors, for example light and heat may cause problems.
• The doses of alfentanil stated below may not always be appropriate if using the 500 micrograms/ml preparation, as the volume of this preparation needed would not fit into the syringe.

Type of pump

Drug combinations

Dilute using 0.9% saline for injection to a final volume of:

17 ml in 20 ml syringe and use BD Bodyguard T pump

22 ml in 30 ml syringe and use BD Bodyguard T pump

24 ml in 50 ml syringe and use non ambulatory pump

48 ml in 50 ml syringe and use non ambulatory pump

Ketamine (alone)

600 mg

600 mg

600 mg

600 mg

Ketamine

Alfentanil

500 mg

6 mg

600 mg

7 mg

600 mg

8 mg

600 mg

15 mg

Ketamine

Dexamethasone*

600 mg

1 mg

600 mg

1 mg

600 mg

1 mg

600 mg

1 mg

Ketamine

Diamorphine

600 mg

500 mg

600 mg

500 mg

600 mg

500 mg

600 mg

500 mg

Ketamine

Haloperidol

300 mg

10 mg

400 mg

10 mg

435 mg

10 mg

600 mg

10 mg

Ketamine

Midazolam

500 mg

35 mg

600 mg

45 mg

600 mg

50 mg

600 mg

100 mg

Ketamine

Morphine

350 mg

180 mg

450 mg

230 mg

490 mg

250 mg

600 mg

500 mg