Syringe driver (continuous infusion under the skin)

A small battery pump that gives a steady flow of symptom-relief medicine through a fine tube just under the skin, used when tablets are no longer suitable — for example if swallowing or keeping things down is difficult.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A syringe driver is a small pump that gives steady symptom relief through a fine soft tube just under the skin, usually refilled every 24 hours.
It is used when tablets are no longer suitable — for example with difficulty swallowing or vomiting — not because the illness has reached any particular point.
Starting one does NOT mean medicines have failed, and it does NOT cause or hasten death — it is a comfort measure.
It can give several medicines at once (for pain, sickness, agitation, breathlessness or secretions) and can be stopped or changed if your needs change.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeContinuous medicine given under the skin by a small pump

AnaestheticNot needed; a fine soft tube is placed under the skin, with little or no pain

How long it takesRuns continuously, usually refilled every 24 hours

Hospital stayOften used at home, in a hospice, care home or hospital; you can usually still move around with it

Time off workNot applicable; the aim is steady comfort

When you'll see resultsSteady symptom relief, usually within a few hours of starting

On the NHS?Widely used free on the NHS and in hospices; private care is mainly for choice or setting

A general guide. Your specialist will give you advice for your situation.

Best fit

Steady, continuous symptom relief without peaks and troughs

Pause if

If you can still swallow and absorb tablets well, these are usually simpler and a pump is not needed.

Main recovery point

A fine soft tube is placed under the skin, usually with little or no pain. The pump starts giving medicine steadily; you can rest, sleep and move around...

Good aftercare

Regular, at least daily, checks of the pump and the skin site, with the site moved if sore

When it is set up

A fine soft tube is placed under the skin, usually with little or no pain. The pump starts giving medicine...

First few hours

Steady relief usually builds within a few hours. Breakthrough doses can still be given separately for any flare-up.

Each day

A nurse checks the pump and the skin site and refills the syringe, usually every 24 hours, adjusting medicines if...

Ongoing

The site is moved if it becomes sore. If your situation improves, the pump can be stopped and tablets restarted.

Medical line illustration of palliative syringe driver for Syringe driver (continuous infusion under the skin). — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a syringe driver?

A syringe driver (also called a syringe pump) is a small, battery-powered pump that gives a steady, continuous flow of medicine through a fine, soft tube placed just under the skin. The syringe is usually refilled once every 24 hours. The pump is small and light enough to carry in a pouch or pocket, so you can usually still move around.

It is used when taking medicines by mouth is no longer suitable — for example, if swallowing has become difficult, if you are being sick and cannot keep tablets down, or if you are very drowsy. It can give several symptom-relief medicines together, such as those for pain, sickness, agitation, breathlessness or chesty 'rattly' secretions.

It is very important to understand what a syringe driver is and is not. Starting one does not mean your other medicines have failed, and it does not cause death or hasten dying. It is simply a reliable, comfortable way to keep giving the medicines your body still needs when tablets are not working well. Many people use a syringe driver for a while and then go back to tablets if their situation improves.

The medicine goes under the skin through a fine tube, so there is only a small needle or soft cannula site — not a drip into a vein, and not surgery.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

For pain relief

Delivers a steady dose of a strong painkiller, often with breakthrough doses still given separately for flare-ups.

For sickness (nausea and vomiting)

Gives anti-sickness medicine continuously when tablets cannot be swallowed or kept down.

For agitation or restlessness

Provides a calming medicine to ease agitation or distress, helping you feel settled.

For chesty secretions ('rattly' breathing)

Delivers medicine that dries up the secretions causing noisy breathing, which can be distressing for families to hear.

A combination

Often two or more compatible medicines are mixed in one syringe so several symptoms are controlled together through a single pump.

Syringe driver compared with tablets

	Tablets / liquids	Syringe driver
Best when	You can swallow and absorb them	Swallowing or keeping things down is hard
How it feels	Doses at set times	Steady, continuous relief
The site	None	A small needle/soft tube under the skin
Reversible?	Yes	Yes — can return to tablets if you improve

A syringe driver is a change of route, not a change in how serious things are. It can be stopped if tablets become suitable again.

Preparing for your treatment

Ask the nurse or doctor to explain why a syringe driver is being suggested and which symptoms it will help.
Tell them about all current medicines so doses can be matched and nothing important is missed.
Ask where the small tube will sit and how the site is looked after.
Ask how often it is checked and refilled, and who does this at home.
Ask what to do if the pump alarms, the site becomes sore, or a symptom is not controlled.
If at home, make sure you have the team's day and night contact number.

What happens

A nurse sets up the pump and places a fine, soft tube just under the skin — often on the upper arm, tummy, chest or thigh. This is usually quick and causes little or no pain, like a small scratch, and no anaesthetic is needed. The tube is held in place with a clear dressing, and the pump sits in a small pouch or holder.

The pump then gives the medicine steadily, usually over 24 hours, after which the syringe is refilled. A nurse checks the pump and the skin site regularly to make sure it is working and comfortable, and changes the site if it becomes red or sore.

Medicines can be added or adjusted in the syringe as your symptoms change. Breakthrough doses for flare-ups are usually still given separately. You can normally move around with the pump, rest, sleep and have visitors as usual.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

If you can still swallow and absorb tablets well, these are usually simpler and a pump is not needed.
If only one or two symptoms need short-term relief, occasional injections or other routes may be enough.
If the skin is very fragile, swollen or broken at the usual sites, a suitable site must be chosen carefully.
It does not treat the underlying illness; it is a way of delivering symptom-relief medicines.

Delay or rearrange if…

There is infection or significant swelling at all the usual skin sites until a suitable spot is found.
The medicines and doses have not yet been worked out, as the syringe contents need to be correct.
A reversible problem (such as treatable vomiting) might soon allow tablets to continue.
Key information about current medicines is missing and would change what goes in the syringe.

Alternatives to discuss

Continuing tablets or liquids if swallowing and absorption are adequate
Medicine patches on the skin for some symptoms, such as pain
Occasional injections under the skin for intermittent symptoms
Other routes such as under the tongue, into the cheek, or rectally for some medicines
Reviewing whether a reversible cause (for example treatable sickness) could allow tablets to continue

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Steady, continuous symptom relief without peaks and troughs
No need to swallow tablets, which helps if swallowing or keeping things down is hard
Avoids repeated injections, as several medicines can run through one pump
Several symptoms — pain, sickness, agitation, breathlessness, secretions — controlled together
Small and portable, so you can usually still move around
Can be stopped or changed back to tablets if your situation improves

Risks & complications

More common

Mild redness, soreness or swelling at the skin site, which is why the site is checked and moved if needed
Side effects of the medicines themselves, such as drowsiness or a dry mouth, depending on what is in the syringe
The site sometimes needing to be re-sited every few days

Less common

A blocked or kinked tube, or the pump alarming, needing a nurse to check it
A reaction or irritation to the dressing or medicine at the site
A symptom not fully controlled, needing the medicines or doses adjusted

Rare but serious

An infection at the skin site
An unexpected reaction to a medicine in the syringe needing prompt review

Most problems are minor and about the skin site — redness or soreness that settles when the tube is moved. The pump is checked regularly so that blockages or alarms are caught quickly. The most important thing to know is reassurance, not risk: a syringe driver is a comfort measure that keeps your medicines going steadily; it does not cause or speed up death. Ask your team what to do if the site is sore or a symptom is not controlled.

Published figures to discuss

A syringe driver is a way of giving medicine rather than a procedure with a defined complication 'rate'. Most issues are minor and relate to the skin site — redness or soreness that settles when the tube is moved — and how often this happens varies between people and sites. The effects you feel come mainly from the medicines in the syringe, which are matched to your symptoms. We have not given fixed percentages because robust, comparable figures do not exist for this; your team can explain what to expect.

Figure	Reported range	How to interpret it	Source / confidence
Site reaction, leakage or needle displacement	Common practical issues	Redness, swelling, pain, wet dressing or alarm should prompt nursing review.	Guide sourcesClinical context
Drug incompatibility or precipitation	Avoidable with specialist checks	Not all medicines can be mixed; compatibility and diluent should be checked.	Guide sourcesClinical context
Over- or under-medication	Dose/prescribing-dependent	The prescription should include indications, breakthrough doses and review after starting.	Guide sourcesClinical context
Family concern that the driver means death is imminent	Common	A syringe driver is a route for medicines when swallowing is difficult or symptoms need steady control; it does not by itself hasten death.	NICE NG31 — Care of dying adults in the last days of lifenice.org.ukSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no recovery in the usual sense. The pump simply delivers your medicines steadily; what matters is that your symptoms are controlled and the skin site stays comfortable, both of which are checked regularly.

When it is set up

A fine soft tube is placed under the skin, usually with little or no pain. The pump starts giving medicine steadily; you can rest, sleep and move around with it.

First few hours

Steady relief usually builds within a few hours. Breakthrough doses can still be given separately for any flare-up.

Each day

A nurse checks the pump and the skin site and refills the syringe, usually every 24 hours, adjusting medicines if symptoms change.

Ongoing

The site is moved if it becomes sore. If your situation improves, the pump can be stopped and tablets restarted.

What's normal — and not a worry

A small dressing over the tube, which may be slightly pink at the site
Steady relief rather than the ups and downs of tablets
Some drowsiness or dry mouth, depending on the medicines used
The site occasionally needing to be moved to a fresh spot

Aftercare

Keep the pump dry and in its pouch or holder; ask before getting it wet (for example when washing).
Do not pull or kink the tube; let it sit loosely.
Tell the nurse if the site becomes red, sore, swollen or leaks.
Let the team know if a symptom is not controlled, so the medicines can be adjusted.
Use any separate breakthrough doses as you have been shown.
If the pump alarms or stops, contact the team rather than trying to fix it yourself.
Keep the day and night contact number to hand if the pump is used at home.

Before your treatment

Clear explanation of why the pump is being used and what is in it
Up-to-date list of all current medicines shared with the team
Instructions on keeping the pump dry and the tube comfortable
Plan for who checks and refills the pump at home, and how often
Separate breakthrough doses available for flare-ups
Day and night contact number saved
Clear advice on what to do if the pump alarms

Scars and how they heal

There are no surgical cuts and no scars. A fine, soft tube (a small needle or cannula) sits just under the skin, held by a clear dressing — usually on the upper arm, tummy, chest or thigh. Putting it in is quick and usually causes little or no pain, like a small scratch. The site may look slightly pink and is moved to a fresh spot every few days, or sooner if it becomes sore, leaving only a tiny mark that settles.

⚠ Get urgent help if…

The skin site becoming red, hot, very sore, swollen or leaking fluid
A symptom such as pain, sickness, breathlessness or agitation that is not controlled
The pump alarming or stopping, or the syringe looking empty earlier than expected
Very slow or shallow breathing, or being very hard to wake
New confusion or distress
The tube coming out or the dressing lifting off
A high temperature or feeling suddenly very unwell

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A working syringe driver gives steady, reliable symptom relief through the skin, usually within a few hours, without needing to swallow anything. It is judged a success when your symptoms are well controlled and the skin site stays comfortable.

It does not treat the underlying illness and does not, by itself, change how the illness progresses — and it does not hasten death. It is a way of delivering medicine, chosen because it suits you better than tablets at that time, and it can be changed or stopped as your needs change.

How long it lasts

A syringe driver is used for as long as it is the best way to give your medicines. For some people that is a short period during a difficult patch; for others it continues. If swallowing and keeping tablets down improves, the pump can be stopped and tablets restarted. The medicines and doses in the syringe are reviewed regularly so they keep matching your symptoms.

Related tests, treatments or support

A syringe driver often runs alongside other care: separate breakthrough doses for flare-ups, mouth care for dryness, and the wider support of a specialist symptom-control team. The medicines inside it are usually the same ones you might otherwise take as tablets — for pain, sickness, agitation, breathlessness or secretions — simply given by a different route.

Follow-up & long-term care

A nurse checks the pump and the skin site regularly, usually at least daily, refilling the syringe and adjusting medicines as needed. At home, the community nursing or palliative care team manages this and is your contact if anything changes. They coordinate with your GP and any hospital or hospice team so the plan stays consistent.

Regular checks of the pump and the skin site, usually at least daily
Refilling the syringe, normally every 24 hours
Moving the site to a fresh spot if it becomes sore
Adjusting the medicines and doses in the syringe as symptoms change
Keeping separate breakthrough doses available for flare-ups

Repeat, follow-on and what comes next

The skin site is expected to be moved to a fresh spot every few days, or sooner if sore.
The medicines and doses in the syringe are commonly adjusted as symptoms change.
The pump can be stopped and tablets restarted if swallowing and absorption improve.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Regular, at least daily, checks of the pump and the skin site, with the site moved if sore
Clear, honest reassurance to patient and family about what the pump is and is not
Separate breakthrough doses available and explained for flare-ups
A named contact and day-and-night route for help if the pump alarms or a symptom is uncontrolled
Joined-up working between community nurses, GP and any hospice or hospital team

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The setting — home, hospice, care home or hospital
Nursing time to set up, check and refill the pump, usually daily
The medicines used in the syringe
The pump, tubing and dressings
How quickly the team can respond if the pump alarms or a symptom flares
Out-of-hours nursing cover, especially at home
Coordination with your GP and other teams

Make sure your written quote includes

Who provides and services the pump, and what nursing visits are included
Whether the medicines, tubing and dressings are included or charged separately
How often the pump is checked and refilled, and by whom
How help is provided if the pump alarms or a symptom is not controlled, including out of hours
How separate breakthrough doses for flare-ups are arranged
What happens, and what it costs, if the site needs frequent re-siting or a complication occurs
How the private team coordinates with your NHS GP and community nursing

On the NHS? Syringe drivers are widely used free on the NHS and in hospices when tablets are no longer suitable; private care is mainly about choice of setting rather than because NHS care is lacking.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Why is a syringe driver right for me now, and which symptoms will it help?
Which medicines will be in the syringe, and what side effects might they cause?
How is the skin site looked after, and what do I do if it becomes sore?
How will I still get extra relief for flare-ups?
Who checks and refills the pump, and how often?
Could I go back to tablets if my swallowing or sickness improves?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Does starting a syringe driver mean the end is near?

Not in itself. A syringe driver is used whenever tablets are no longer the best route — for example with difficulty swallowing or vomiting. It is a change of route, not a sign of any particular stage, and it can be stopped if tablets become suitable again.

Will the syringe driver speed up dying?

No. A syringe driver gives the same kinds of symptom-relief medicines you might otherwise take as tablets, at doses matched to your symptoms. It is a comfort measure and does not cause or hasten death.

Is it painful to have one?

Putting in the fine soft tube is usually quick and causes little or no pain, like a small scratch, and no anaesthetic is needed. The site may feel slightly tender and is moved if it becomes sore.

Can I still move around, wash and sleep?

Usually yes. The pump is small and portable and sits in a pouch or pocket. Ask your team about keeping it dry when washing, but you can normally rest, sleep and have visitors as usual.

Does it mean I cannot take any tablets at all?

Not necessarily. Some medicines may still be given another way, and breakthrough doses for flare-ups are usually given separately. If you improve, the pump can be stopped and tablets restarted.

Is it available on the NHS?

Yes. Syringe drivers are widely used free on the NHS and in hospices when tablets are not suitable. Private care is mainly about choice of setting rather than because NHS care is lacking.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Marie Curie — Managing symptoms (terminal illness) Marie Curie — Feeling sick and vomiting: causes and treatments palliativedrugs.org — Syringe driver patient information leaflet (PDF) NICE NG31 — Care of dying adults in the last days of life Hospice UK — Information and support

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.