All about acetaminophen—I.V.!
Aaron Segobiano MSN, RN, CMSRN
James Waters RN
Charlotte Davis BSN, RN, CCRN

Nursing Made Incredibly Easy!
April 2014 
Volume 12  Number 2
Pages 50 - 52
  PDF Version Available!

Approved by the FDA in 2010, the I.V. form of acetaminophen (ofirmev injection) is indicated to manage mild-to-moderate pain or moderate-to-severe pain with an adjunctive opioid. It can also be used to reduce fever. Let's take a closer look.Administering acetaminophen I.V. rather than orally may be indicated for patients who are: * experiencing nausea, vomiting, or diarrhea * critically ill * NPO * experiencing a decreased level of consciousness * receiving numerous medications by mouth * being treated with medications known to cause nausea and vomiting, such as chemotherapy agents.It's contraindicated for patients with known hypersensitivity to acetaminophen or any components of the I.V. formulation, and in patients with severe hepatic impairment or severe active liver disease. For more information, see Contraindications, warnings, and precautions.I.V. acetaminophen is currently approved only for patients age 2 and older. The Pediatric Equity Research Act of 2003 requires controlled clinical trials on drugs intended for pediatric patients. The drug's manufacturer is currently conducting research to evaluate the safety and effectiveness of administering acetaminophen via the I.V. route in children under age 2.Patients taking certain medications may experience a drug-drug interaction when two or more specific medications are mixed or taken within a short period of time. Drug-drug interactions can cause signs and symptoms ranging from minor itching or a rash to serious, potentially life-threatening complications such as breathing difficulties, predisposition to hemorrhage, and cardiac dysrhythmias.Patients taking oral anticoagulants such as warfarin concurrently with oral acetaminophen are at increased risk for bleeding. Although research on ofirmev is limited, patients taking anticoagulants should be monitored for signs of bleeding, such as hematuria, melena, bleeding gums, and nose bleeds, when being given I.V. acetaminophen. In addition, monitor serum lab values closely,

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