Study: IV acetaminophen just as effective as oral Tylenol in bowel procedures

June 20 (UPI) — Intravenous acetaminophen had no additional benefits over oral Tylenol for patients undergoing colorectal procedures, according to a new study.

Researchers at Mount Sinai concluded that hospital elimination of IV acetaminophen will have significant cost savings but no impact on patients’ experience or outcomes compared with the oral version of the drug. The study was published in the July issue of Anesthesiology.

IV acetaminophen, marketed as Ofirmev and manufactured by Mallinckrodt Pharmaceuticals, was introduced in the United States in 2010. A typical tablet dose of acetaminophen costs a few cents, but the IV version’s wholesale is $13 for a 1 gram vial, according to Pharmacy Times.

While non-opioid pain medications are a common substitute for opioids, researchers said it is unclear how effective this drug was for surgery patients.

“With any new drug that is introduced to the U.S. market, it is very important to monitor how it is used and if this results in the desired outcomes,” Dr. Jashvant Poeran, an assistant professor of Population Health and Health Science Policy at the Icahn School of Medicine, said in a press release. “Our study results do not support routine use of IV acetaminophen.”

For the new study, researchers analyzed data on 181,640 people who underwent open bowel surgery in 602 hospitals across the United States between 2011 and 2016.

They found that IV acetaminophen was used in 25.1 percent of cases, of which nearly half received only one dose, on the day of surgery. They found IV acetaminophen use was not associated with clinically significant reductions in opioid utilization, despite this being one of the primary motivators for using it.

Researchers also report that oral Tylenol was as effective as the IV option or better, especially among patents with more than one dose on the day of surgery. The researchers noted that IV acetaminophen might be a better for choice for those who cannot tolerate oral medication.

“It is important that we that we identify optimal dosing strategies and patients that are most likely to benefit from this relatively new drug,” Poeran said.

Researchers want to conduct studies on those who undergo hip, knee and shoulder replacement.

In a study earlier this year, researchers at the Minneapolis Veterans Affairs Health Care System found opioids were no better at managing chronic back pain or hip and knee pain than non-opioid pain treatments.

“A wide variety of non-opioid adjuvants are available for use, but our knowledge of what works best in whom is still in its infancy,” said Dr. Andrew Leibowitz, a professor of anesthesiology at School of Medicine at Mount Sinai. “Intuitively, greater effectiveness is expected with more different classes of medications administered while also decreasing side effects of any one of them.”

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