Newport Centerfor Special Surgery

Your Pain and Nausea Medication Plan

Painting of a woman resting comfortably with a cup of tea beside a sunlit window overlooking the ocean.
Rest-Assure Program

Your Pain and Nausea Medication Plan.

A non-opioid plan to keep you comfortable after surgery, developed at Newport Center for Special Surgery. Follow it alongside your surgeon's instructions.

Morning of surgery: 2 + 2 + 1. Then: 1 + 1 every 12 hours.

The first morning dose is bigger and includes a nausea pill. From that evening on, it's one Journavx and one celecoxib, twice a day.

Step by step

Your medication schedule.

3 nights before surgery

Only if your surgeon prescribes it

Clonidine patch, for blood pressure that was high at your pre-op visit. Apply it at bedtime, three nights before surgery. The patch lasts 1 week. Leave it on until your surgeon tells you to remove it.

Morning of surgery

Before you leave home, with a small sip of water

  • 2 Journavx (suzetrigine) 50 mg tablets, 100 mg total, on an empty stomach
  • 2 celecoxib (Celebrex) capsules
  • 1 nausea pill: Zofran (ondansetron) or Emend (aprepitant), whichever your surgeon prescribed. Not both.
  • If prescribed: scopolamine patch behind one ear, for patients who have had nausea after past surgeries

Evening of surgery

About 12 hours after your morning dose

  • 1 Journavx tablet (50 mg)
  • 1 celecoxib capsule
  • Zofran only if you feel nauseated

No need for an empty stomach. Take with or without food.

No nausea? You may remove the scopolamine patch tonight.

Every 12 hours after

Morning and evening, for example 7 AM and 7 PM

  • 1 Journavx tablet
  • 1 celecoxib capsule
  • Emend: 1 capsule the next morning, only if you are still nauseated

Continue until your surgeon tells you to stop. Celecoxib is easier on the stomach with food.

Woman resting comfortably with a cup of tea beside a sunlit window overlooking the ocean.
From the Journal

Why the plan works this way.

Three medicines, one schedule, and why staying on time makes recovery easier.

Read the article →

Nausea medicine

Zofran (ondansetron): after your morning dose, you may take more only if you feel nauseated. No more than 4 tablets a day, counting the morning dose, at least 6 hours apart.

Emend (aprepitant): one capsule the morning of surgery. Take one more the next morning only if you are still nauseated.

Extra pain relief: Tylenol

You may take rapid-release acetaminophen (Tylenol), one 500 mg tablet every 4 hours, in between your Journavx and celecoxib doses. No more than 8 tablets (4,000 mg) a day, counting any acetaminophen in other medicines, like cold remedies.

About the patches

Scopolamine (for nausea), if prescribed

Place it on clean, dry skin behind one ear on the morning of surgery. Wash your hands right after touching it; getting it in your eyes can blur your vision. Dry mouth and drowsiness are common. If you have no nausea, you may remove it the evening after surgery. Fold it in half, throw it away, and wash your hands.

Clonidine (for blood pressure), if prescribed

Apply it three nights before surgery. Each patch lasts 1 week. It can cause drowsiness or lightheadedness, so stand up slowly. Don't remove it early on your own; ask your surgeon when to stop.

Important

  • Tell your surgeon before surgery if you are allergic to sulfa drugs, aspirin, or NSAIDs, or have had stomach ulcers or bleeding, kidney, liver, or heart disease, or if you are pregnant or breastfeeding.
  • No grapefruit or grapefruit juice while taking Journavx.
  • No ibuprofen (Advil, Motrin) or naproxen (Aleve). Celecoxib is already an anti-inflammatory.
  • Birth control: Journavx can make some hormonal birth control less effective. Use a backup method, like condoms, while taking it and for 28 days after.
  • Don't drive while taking any opioid pain medicine, or if you feel drowsy or dizzy. The scopolamine and clonidine patches can cause both.
  • Missed a dose? Take it when you remember, unless the next dose is due within 6 hours. Never double up.
  • Call us at (949) 644-8182 for pain that isn't controlled, vomiting, a rash, or any concern. For an emergency, call 911.

Prefer paper? The printable plan includes a dose tracker you can check off each day.

Download the printable plan (PDF)

This page is general information for NCSS patients. If your surgeon's instructions differ, follow your surgeon.