From the FDA Drug Label
2 DOSAGE & ADMINISTRATION
OFIRMEV may be given as a single or repeated dose for the treatment of acute pain or fever.
2.5 Instructions for Intravenous Administration
For adult and adolescent patients weighing ≥ 50 kg requiring 1000 mg doses of OFIRMEV, administer the dose by inserting a vented intravenous set through the septum of the 100 mL vial or a non-vented intravenous set through the administration spike port of the 100 mL bag.
Appropriate Antipyretic for NPO Patient:
- IV Acetaminophen is an appropriate antipyretic for a patient who is Nil Per Os (NPO, nothing by mouth) as it can be administered intravenously.
- The recommended dosage of IV acetaminophen for adults and adolescents weighing 50 kg and over is 1000 mg every 6 hours or 650 mg every 4 hours, with a maximum single dose of 1000 mg and a maximum daily dose of 4000 mg per day 1.
From the Research
For a patient on NPO (nothing by mouth) status who needs an antipyretic, intravenous acetaminophen is the preferred option, administered at 1,000 mg every 6 hours for adults (15 mg/kg for children), with a maximum daily dose of 4,000 mg, as it provides a rapid and effective reduction in fever 2.
Key Considerations
- The choice of antipyretic should be based on the patient's medical history, reason for NPO status, and expected duration of this restriction.
- Intravenous acetaminophen has been shown to be safe and effective in reducing fever in patients who are unable to tolerate oral administration or when rapid reduction of temperature is desirable 2.
- Other options, such as rectal acetaminophen suppositories, may also be considered, but intravenous acetaminophen is generally preferred due to its faster onset of action and higher efficacy 3, 4, 5.
- Parenteral NSAIDs like ketorolac may be used as an alternative, but their use should be carefully considered due to the potential risks of renal dysfunction and bleeding 6.
Administration and Dosage
- Intravenous acetaminophen should be administered at a dose of 1,000 mg every 6 hours for adults (15 mg/kg for children), with a maximum daily dose of 4,000 mg.
- The medication should be infused over 15 minutes to minimize the risk of adverse reactions.
- Patients should be closely monitored for signs of adverse reactions, such as allergic reactions, constipation, and dry mouth 2.
Additional Measures
- In hospital settings, cooling measures such as cooling blankets or ice packs may be used to supplement pharmacological approaches and help reduce fever.
- The patient's temperature should be closely monitored, and the antipyretic medication should be adjusted as needed to maintain a safe and comfortable temperature.