Reply To: Tylenol administration for febrile BMT patients

  • JD Murphy

    November 27, 2021 at 5:35 pm

    Hi there. We don’t restrict Tylenol use unless they are high risk for VOD. In that case, we minimize use to by provider order only (not a PRN order), so that it can be fully evaluated if the patient truly needs it. There isn’t a set temperature criteria. Around busulfan however, that’s a definite no Tylenol no matter how high a fever. Will add the caveat that we have a NP-lead coverage during the day, so are better able to evaluate the risks/benefits prior to each administration over say a resident-lead service that might not know BMT as well. Maybe they’ve had a prior bad experience at this hospital? Definitely worth taking a deeper dive into the why at your new center.

    Hope this helps.


    Pediatric Oncology/BMT Nurse Practitioner
    Johns Hopkins Hospital
    Baltimore, MD USA
    Original Message:
    Sent: 11-26-2021 10:36 PM
    From: Loren Tilson
    Subject: Tylenol administration for febrile BMT patients

    Do any of the hospitals you work at have restrictions for Tylenol usage in bmt patients for VOD prophylaxis?  Where I used to work, we gave Tylenol for fevers like it was no big deal, but I moved to a different hospital where they very rarely allow us to give Tylenol and will often wait until a patient’s temp is as high as 103 F.  We had very few issues with VOD where I worked before even though we frequently gave Tylenol. So, what do you guys do? Tylenol or no??

    Loren Tilson, RN
    Charleston, SC
    United States