Patients with end stage renal disease under hospice care usually need medications for symptom relief. Medications for pain, dyspnea, nausea and vomiting, and anxiety are often prescribed. Concerning the unusual pharmacokinetics in patients with renal failure, it should be cautious about the appropriateness of medications and its dosages, as well as the possible adverse drug reactions to achieve the best treatment effect. This article summarizes the dosage adjustment and special precautions of the commonly used medications in hospice care of renal failure.