Dexmedetomidine (DXM) is an alpha-2 adrenoreceptor agonist of interest in palliative care.1 2 It has been conventionally used in intensive care for sedation (with rousability) and refractory neuropathic pain, and ventilator weaning.3 There is minimal literature in palliative care, with case reports for use in refractory cancer pain, and as a sedative, and retrospective chart analyses of use for sedation in terminal heart failure.4–6

End-of-life-care drugs in palliative medicine are often given subcutaneously, with the syringe driver the tool of choice in multiple settings.7 A syringe driver allows multiple medications in a single syringe, if compatibility permits.7 Although DXM is well tolerated subcutaneously with minimal side effects,8 it is unclear whether it can be given along with other medications in a single syringe, which would expand utility. There are laboratory compatibility data …