Acetaminophen IV restrictions

Please read this important memo about our new policy restricting use of Acetaminophen IV.

TO:                  All Attending and House Staff Physicians
FROM:            P&T Committee and Medical Staff Executive Committee
DATE:              January 15, 2014
RE:                  IV Acetaminophen Use

The use of IV acetaminophen has continued to increase since its addition to UNC’s formulary.  The Pharmacy and Therapeutics (P&T) Committee has approved the clinically appropriate use of IV acetaminophen (Ofirmev®) only in situations where oral or rectal acetaminophen cannot be used.  A recent review of IV acetaminophen usage within UNC Hospitals showed that the majority of orders for this product were not compliant with approved usage.  There were also patient safety concerns found during this review regarding total dosage of acetaminophen administered.  Additionally, it is important to remember that the use of IV acetaminophen is significantly more expensive ($50/day) and there are no data to support superior efficacy. 

Based upon these results and after polling similar institutions, the P&T Committee has approved a 24 hour automatic stop date on every order.  In addition, pharmacists may change patients from IV to PO acetaminophen at the time they meet the criteria for PO intake, as outlined in the following policy: 

http://intranet.unchealthcare.org/policies/pharmacy/pharmacy_inpatient/PHARM0211.pdf

We are asking for your support of the appropriate use of IV acetaminophen.  If you have a patient you believe is an exception to this policy, please contact the pharmacist covering your service and discuss the patient’s needs.   Providers will be expected to offer clinical evidence for the need to prescribe the medication outside of the P&T approved restriction in order to gain approval for use. 

If you have concerns or would like to request that the Committee consider any changes to current formulary restrictions (for this medication or others), please contact Ashley Lewis, PharmD, Secretary (alewis@unch.unc.edu) or Abhi Mehrotra, MD, Chair, of the P&T Committee.  

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Click here for a printable version of the letter from the P&T Committee and Medical Staff Executive Committee to all attending and house staff physicians.

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