The IV formulation (Ofirmev) is RESTRICTED.  Use is allowed in patients who meet one of the below criteria:

1. In surgery patients > 2 years of age may receive 1 dose of IV acetaminophen. It may only be ordered by an attending anesthesiologist and should be communicated in handoff with the next dose of acetaminophen timed appropriately.
2. For use outside the OR patients must meet the below criteria:
   • Have a contraindication to taking medication via the oral route (e.g. NPO, excessive vomiting, mucositis, combative) and
   • Have a contraindication (e.g. neutropenia, obstruction) to taking medication via the rectal route (NOT required if > 6 years of age or combative) and
   • Have a contraindication to IV NSAIDs or who are on scheduled IV NSAID without adequate response.

If patient meets #2 criteria a pharmacist may place an order for IV acetaminophen for 48 hours. 

• Orders for pain control must have a scheduled frequency. 
• Orders for fever control may be PRN. 
• Orders for PDA closure may be entered using the PDA closure OS by the prescriber and are not restricted to 48 hours, but the patient has to meet the restriction criteria for use.

Patients can be re-evaluated for continuation of IV acetaminophen every 48 hours.

All other IV acetaminophen use requires approval by Pharmacy Leadership. 

Acetaminophen doses should not be administered in excess of 75 mg/kg/day or 4 grams/day whichever is lower.

• Micromedex Drug Information
• FDA Daily Med Package Insert
• Recent Citations via Medline (PubMed)
• WebMD Pill Identifier