Six Months of Using Journavx in My Post-Op Patients: Here's How It's Going

Journavx (suzetrigine) is the new non-opioid pain medication that was FDA-approved earlier this year and hit pharmacies in March. I've been using it routinely in my post-op patients for about six months now, and I want to share what I've actually seen — both the genuinely exciting results and the real concerns.

This isn't a sponsored post. It's an honest take from a surgeon who has been watching this medication change how my patients recover.

Journavx (the brand name; suzetrigine is the generic) is:

• A non-opioid pain medication
• The first new class of acute pain medication approved in decades
• Works by blocking a sodium channel (Nav1.8) involved in pain signaling, peripherally
• Does not act on opioid receptors — so no euphoria, no respiratory depression, no addiction risk associated with opioids
• Taken twice a day orally

It's genuinely the kind of innovation we've been waiting for in post-op pain management.

I want to be clear about how Journavx fits into a multimodal pain protocol. It is not used in isolation — and that's actually how non-opioid pain management is supposed to work. My current post-op protocol includes:

• Nerve blocks with a long-acting local anesthetic in the operating room
• Around-the-clock Motrin (ibuprofen)
• A prescription for an opioid medication to be used as needed
• And now, Journavx around-the-clock

A key piece of how I use Journavx: patients take a loading dose of 2 pills with a sip of water right before they go into the operating room. This means the medication is already at therapeutic levels when they wake up from anesthesia and the post-op pain begins.

This is one of the reasons I think it's working so well — we're not waiting until pain is already in full swing to start the medication. We're ahead of it from the beginning.

This has been the most striking change in six months. My patients have always taken relatively few opioids — it's rare for one of mine to need significant amounts post-op. But since adding Journavx:

• Patients almost universally have full or nearly-full bottles of opioids at one month post-op
• I'm getting regular questions about how to dispose of unused opioids — which is honestly a great problem to have
• Many patients are saying they used zero or one or two opioid pills total

This matches what I previously wrote about opioid pills after mastectomy with implant reconstruction — we are dramatically overprescribing opioids relative to what patients actually need, and a tool like Journavx makes that gap even bigger.

I asked my anesthesiologists to track how much opioid they were administering during surgery to see if Journavx was making a difference there too. Over six months:

• They've been giving less intraoperative opioid to my Journavx patients
• The patients are responding to surgery comfortably with less opioid load on board

This matters because opioid use during surgery contributes to post-op nausea and vomiting, prolonged sedation, and a slower wake-up. Less intraoperative opioid = faster, cleaner recovery in PACU.

Patients often ask why we care so much about minimizing opioids. Let me be clear: I'm not an opioid abolitionist. For patients in severe pain — including chronic pain patients with appropriate, supervised management — opioids are an important tool.

But for elective post-op pain in healthy patients:

• Opioids cause real complications that worsen outcomes
• Nausea and vomiting — patients hate this and it slows recovery
• Constipation — sometimes severe enough to require additional intervention
• Sedation — limits early ambulation, which matters for DVT prevention and overall recovery quality
• Dependence and addiction risk in vulnerable patients

A pain plan that delivers good pain control with less opioid use is just objectively better for patient experience and safety.

Honestly, the patient reception has been remarkable. The combination of:

• Nerve blocks at surgery (initial coverage)
• Around-the-clock Motrin and Journavx (continuous baseline coverage)
• Opioid available if needed (rescue only)

…has produced what I'd call the best pain control I've seen in my career for elective surgery patients.

I'll be honest about my concerns, because they're real.

Journavx is currently about $30 for a two-week supply — with a manufacturer coupon. Every patient gets the coupon right now, so the cost is manageable.

Two weeks is more than enough Journavx for most of my patients, since acute post-op pain is usually largely resolved within that window anyway.

This is what I'm genuinely worried about. Manufacturer coupons typically expire, often after the first year or two of the drug being on the market. When that happens:

• The actual list price of Journavx will become more visible
• My suspicion is it'll be significantly more expensive than the current $30 effective price
• That cost barrier may mean fewer patients can access it going forward

I really hope the price stays accessible. We've had such a positive experience with this medication that I'd hate to see it become a tool only available to higher-income patients.

The current Journavx coupon is only available for patients 18 years and older, because that was the age range studied in the FDA trials.

I occasionally treat adolescent patients for:

• Tuberous breast corrections
• Breast reductions in young women with significant macromastia

For these younger patients (who would benefit just as much from Journavx), we have to:

• Try to obtain samples for off-label use, or
• Have them pay fully out of pocket, which is expensive

This is a real gap that I hope gets addressed as the pediatric data accumulates.

No medication is perfect, and no medication works for every single patient. There are absolutely some patients in my practice who haven't had the same dramatic response — but the vast majority have had a great experience and have told me Journavx made a meaningful difference.

I'm going to continue using it routinely with my patients. It's become a core part of my multimodal pain protocol, and the combination has produced the best outcomes I've seen.

If you're scheduled for surgery — particularly an elective procedure — it's worth asking your surgeon:

1. "What is your multimodal pain plan?"
2. "Are you using Journavx (suzetrigine)?"
3. "What's the opioid component, and what would I do if I needed less of it?"

A surgeon who's built a thoughtful, modern pain plan will have clear answers — and increasingly, Journavx is becoming part of those plans. (If you're a chronic pain patient with established opioid management — this conversation is different, and your existing plan should be respected. This post is specifically about acute, elective surgical pain in patients without chronic pain conditions.)

After six months of using Journavx in my post-op patients:

• Patients are taking dramatically less opioid — many take zero
• Anesthesiologists are using less intraoperative opioid
• Recovery feels cleaner and more comfortable for patients overall
• Cost is manageable right now with manufacturer coupons (~$30 for two weeks)
• The coupon situation and pediatric access are concerns I'm watching

This is genuinely the most exciting addition to post-op pain management I've seen in my career. I really hope it stays accessible — because it's making real differences in patient experience.