Ofirmev:  Formulary agent restricted to:

• One-time dose in PACU to treat pain in patients meeting criteria per the OSA Risk Assessment screening tool
• Control of fever in neutropenic patients who are unable to receive oral/rectal APAP or IV ketorolac (Dosing restrictions:  q6h prn fever x 3 doses, automatic 24 hour hard stop)
• Abdominal surgery patients greater than or equal to 70 years of age OR with a BMI greater than or equal to 40:  1g on call to OR, then 1g q6h x3 additional doses
• Bariatric surgery patients 1g q6h x3 doses
• Thoracic surgery patients: undergoing thoracotomy procedure only and ordered via the CT surgery thoracotomy post-op order set:  6 doses post-op (in addition to intraoperatively x 1 dose). Doses must be ordered by a CVT surgeon. 
• Colorectal Surgery: intraoperatively x 1 dose
• CT Surgery: to be given by anesthesia intraoperatively x1 dose ordered from the pre-op order set. All other orders require approval.
• Head and Neck ERAS: intraoperatively x 1 dose per ERAS protocol
• Any ERAS protocol: intraoperatively x 1 dose per ERAS protocol

All other orders for Ofirmev must be approved by Dr. Gremillion or Dr. Thomas prior to dispensing.

Ofirmev (IV Acetaminophen) Executive Summary

Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note:  “Therapeutic Interchange” should be placed in the order comments

• UpToDate
• FDA Package Inserts