Diamorphine (10mg, 30mg, 100mg amps.)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 2.5-5mg PRN 4hrly | 15 x 10mg | 15 x 10mg | 15 x 10mg |
10mg/24h | 2.5-5mg PRN 4hrly | 15 x 10mg | 20 x 10mg | 20 x 10mg |
20mg/24h | 5mg PRN 4hrly | 15 x 10mg | 20 x 10mg | 25 x 10mg |
30mg/24h | 5mg PRN 4hrly | 5 x 30mg 10 x 10mg | 5 x 30mg 15 x 10mg | 10 x 30mg 15 x 10mg |
40mg/24h | 5-10mg PRN 4hrly | 5 x 30mg 15 x 10mg |
10 x 30mg 15 x 10mg |
10 x 30mg 20 x 10mg |
50mg/24h | 5-10mg PRN 4hrly | 10 x 30mg 10 x 10mg |
10 x 30mg 15 x 10mg |
15 x 30mg 20 x 10mg |
60mg/24h | 10mg PRN 4hrly | 10 x 30mg 10 x 10mg |
10 x 30mg 15 x 10mg |
15 x 30mg 20 x 10mg |
70mg/24h | 10mg PRN 4hrly | 10 x 30mg 15 x 10mg |
15 x 30mg 20 x 10mg |
15 x 30mg 25 x 10mg |
80mg/24h | 10mg PRN 4hrly | 10 x 30mg 10 x 10mg |
15 x 30mg 15 x 10mg |
20 x 30mg 20 x 10mg |
90mg/24h | 15mg PRN 4hrly | 10 x 30mg 15 x 10mg |
15 x 30mg 20 x 10mg |
20 x 30mg 25 x 10mg |
Opioid Patches
For patients on opioid patches, a prescription should be given for diamorphine to cover the need for PRN or increase in analgesia. Calculate the equivalent diamorphine daily dose of the opioid patch (e.g. fentanyl 75µg/h patch → diamorphine 90mg/24h); in the table, use the row corresponding to approximately 2/3rds of this dose i.e. 60mg/24h.
Alternatives to Diamorphine
If diamorphine is unavailable, or inappropriate to use, morphine (10mg/mL and 30mg/mL ampoules) or oxycodone (10mg/1mL, 20mg/2mL, or 50mg/1mL) can be used as alternatives, and will mix with other drugs in a syringe driver similarly to diamorphine.
Approximate Equivalent Doses
Orally (24h dose) | By Injection (24h dose) |
Morphine 30mg = Oxycodone 15mg | Diamorphine 10mg = Oxycodone 10mg = Morphine 15mg |
Oxycodone (10mg in 1mL, 20mg in 2mL, 50mg in 1mL amps.)
Daily dose CSCI |
SC PRN | 3 days | 4 days | 5 days |
- | 2.5-5mg PRN 4hrly | 15 x 10mg | 15 x 10mg | 15 x 10mg |
10mg/24h | 2.5-5mg PRN 4hrly | 15 x 10mg | 20 x 10mg | 25 x 10mg |
20mg/24h | 5mg PRN 4hrly | 15 x 10mg | 25 x 10mg | 30 x 10mg |
30mg/24h | 5mg PRN 4hrly | 20 x 10mg | 25 x 10mg | 10 x 20mg 15 x 10mg |
40mg/24h | 5-10mg PRN 4hrly | 20 x 10mg | 10 x 20mg 15 x 10mg | 15 x 20mg 15 x 10mg |
50mg/24h | 5-10mg PRN 4hrly | 5 x 50mg 10 x 10mg | 5 x 50mg 15 x 10mg | 5 x 50mg 20 x 10mg |
60mg/24h | 10mg PRN 4hrly | 5 x 50mg 10 x 10mg | 5 x 50mg 15 x 10mg | 10 x 50mg 15 x 10mg |
Morphine (10mg in 1mL, 30mg in 1mL amps.)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 5mg PRN 4hrly | 15 x 10mg | 20 x 10mg | 25 x 10mg |
20mg/24h | 5mg PRN 4hrly | 15 x 10mg | 20 x 10mg | 25 x 10mg |
30mg/24h | 5mg PRN 4hrly | 5 x 30mg 10 x 10mg |
5 x 30mg 15 x 10mg |
10 x 30mg 15 x 10mg |
40mg/24h | 5-10mg PRN 4hrly | 5 x 30mg 15 x 10mg |
10 x 30mg 15 x 10mg |
10 x 30mg 20 x 10mg |
60mg/24h | 10mg PRN 4hrly | 10 x 30mg 10 x 10mg |
10 x 30mg 15 x 10mg |
15 x 30mg 20 x 10mg |
90mg/24h | 15mg PRN 4hrly | 10 x 30mg 15 x 10mg | 15 x 30mg 20 x 10mg | 20 x 30mg 25 x 10mg |
Midazolam (10mg in 2mL amps)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 2.5-5mg PRN 4hrly | 10 | 10 | 10 |
10mg/24h | 2.5-5mg PRN 4hrly | 10 | 20 | 20 |
20mg/24h | 5mg PRN 4hrly | 20 | 20 | 20 |
40mg/24h | 5-10mg PRN 4hrly | 20 | 30 | 30 |
60mg/24h | 10mg PRN 4hrly | 30 | 40 | 40 |
Cyclizine (50mg in 1mL amps.)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 50mg PRN 8hrly | 15 | 15 | 15 |
150mg/24h | 50mg PRN 8hrly | 15 | 20 | 25 |
Hyoscine hydrobromide (0.4mg in 1mL amps.)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 0.4mg PRN 4hrly | 20 | 20 | 20 |
1.6mg/24h | 0.4mg PRN 4hrly | 20 | 25 | 30 |
Levomepromazine‡ (25mg in 1mL amps.)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 6.25mg PRN 4hrly | 10 | 10 | 10 |
12.5mg | 6.25mg PRN 4hrly | 10 | 15 | 15 |
The same prescription for levomepromazine is required for 6.25mg - 25mg/24h and up to 25mg 4hrly PRN
Haloperidol‡ (5mg in 1mL amps.)
Daily dose CSCI | SC PRN | 3 days | 4 days | 5 days |
- | 2.5-5mg PRN 8hourly | 10 | 10 | 10 |
2.5mg/24h (up to 5mg/24h) | 2.5-5mg PRN 8hourly | 10 | 15 | 15 |
10mg/24h | 5mg PRNN 4hrly | 15 | 20 | 20 |
‡ If required
Water for injection
Water for injection 10 x 10mL ampoules should be added to every prescription.