OFIRMEV APPROVED USES:

• Adults: Treatment of fever in ICU or oncology patients who are not candidates for injectable ketorolac or oral/rectal acetaminophen.

• Pediatric patients meeting the following criteria and guidelines:
  • PDA treatment AND patient is unable to tolerate PO acetaminophen
  • Fever meeting all of the following criteria:
    • Strict NPO (including no enteral feeds)
    • Nothing PR
    • Contraindication to NSAIDS -- with at least one of the following:
      • Age <6 months
      • Allergy to NSAIDS
      • GI Bleed
      • Platelet count < 150,000
      • CrCl < 30 mL/min
      • Concurrent use of other nephrotoxic medications (vanco, aminoglycosides, etc.)
      • Other reason explained
  • Pain/Analgesia meeting the following criteria (approved by HVCC, pediatric only - 6 month trial period)
    • NPO and NPR
    • At high risk for narcotic ADRs
    • Must use approved protocol

Ofirmev may be automatically converted to PO (1:1 dose ratio) once the patient meets approved criteria.

The Acetaminophen Protocol for Non-Opioid Pain Management  was approved for pharmacists to place orders for acetaminophen 650 mg q4 hr prn mild pain (pain score 1-3) for adult patients (>17 yo) who have prn opioids ordered without a non-opioid alternative (Acetaminophen or NSAIDs) for mild pain. See linked tip sheet for additional information.

Pharmacists are allowed to automatically adjust regimens (including discontinuation) of scheduled acetaminophen based on not exceeding 4 g of acetaminophen from all sources. Pharmacists are to leave the automatic acetaminophen adjustment communication form on the chart if adjustments are made.

Tylenol Dissolve Packs: Restricted to patients undergoing bariatric surgery.

Reviewed: February 22, 2011 and December 13, 2011 and September 26, 2012 and 26 January 2016 (Ofirmev), and 27 Feb 2018 (Ofirmev), and May 2021 (Tylenol Dissolve Packs)

High Value Care Committee: April 2018 (Ofirmev-Pediatric-Analgesia)

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