It has been a long time coming…two decades. There hasn’t been a new pain medication that is non-narcotic since the turn of the century, but here it is. Journavx is pronounced “Jur Na Vix”, and the generic name is suzetrigine, which can challenge even Francophone speakers. It is a unique drug in that it bypasses the central nervous system (the brain and spinal cord), and operates on the peripheral nervous system (all the nerves that shoot out from the spinal cord to the organs, muscles, joints and skin). With the strong emphasis by the government and medical establishment to crack down on narcotic prescriptions, this could be a godsend. It has been found to be particularly useful for moderate to severe acute pain and post-operative surgical pain.
The medication is still new, and we expect more testing, as at this time, there are limitations, such as not yet being approved for pediatric patients. It is also only recommended for use up to fourteen days, as it wasn’t studied for longer than that. There are some other limitations that we’ll get to shortly.
What you need to know and where your concierge physician will help you along:
The Dosage:
You need a loading dose with this medication. You take two 50mg Journavx tablets on an empty stomach, either one hour before or two hours after food for this first dose. This is followed by a 50mg tablet every twelve hours, which can be taken with or without food. If you miss a dose, just take it as soon as you remember and reset the twelve-hour clock from that time.
Side Effects:
The majority of side effects are limited and mild. Primarily, they include itching, muscle spasms, increased levels of a muscle protein called CPK or creatine phosphokinase, and rash.
Contraindications:
Journavx stimulated an enzyme in the body called CYP3A4. There are many drugs that are CUP3A4 Inhibitors, and these need to be avoided. Examples include
Antibiotics: clarithromycin, erythromycin, telithromycin
HIV Inhibitors: ritonavir, saquinavir, lopinavir
Others: Diltiazem, verapamil, ketoconazole, itraconazole, midazolam and grapefruits
Other Issues:
Your concierge physician will help you understand the nuances in using Journavx. In time, as with all medications, new recommendations and guidelines may arise. We keep our finger on that pulse and guide you in medication management.
There is no information on Journavx’s use in pregnancy or during breastfeeding. It may temporarily reduce the chance of becoming pregnant while on the medication. This area will need further studies before the FDA approves it for pregnancy or clears it while breastfeeding.
If one is on birth control pills other than levonorgestrel and norethindrone, one should use an alternative birth control method for twenty-eight days after finishing Journavx. These include other hormones and non-hormone methods such as condoms.
In patients with kidney issues, no dose adjustment is needed if the glomerular filtration rate is greater than 15. If it is less, then Journeyx should not be used.
For those patients who have liver disease, the medication is likely best avoided. Adverse reactions are more likely.
It is great to finally have another option for pain control. This medication, in theory, is non-addictive, and that is a tremendous plus. It has a simple regimen that should make it easy for patients to follow and thus be compliant. Furthermore, you can store Journavx at room temperature. All in all, this looks to be a winner for patients with moderate to severe acute pain.
We at The Village Doctor will be happy to help counsel you in the use of this promising medication and prescribe when appropriate.
Wishing you health and fitness
Alan Spira, MD, & DTM&H, June 2025
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