Generic Name

Jubbonti

Mechanism

• TRPA1 Inhibition : Jubbonti covalently binds the ATP‑binding pocket of TRPA1, irreversibly preventing channel activation by pro‑inflammatory stimuli (e.g., reactive oxygen species, acrolein).
• Neuroinflammation Attenuation : By blocking TRPA1, Jubbonti reduces Ca²⁺ influx, dampening downstream release of neuropeptides (substance P, CGRP) and cytosolic nitric oxide synthase activity.
• Central Sensitization Modulation : Chronic TRPA1 blockade lowers excitatory synaptic transmission in the dorsal horn, decreasing wind‑up and allodynia.
• Safety Profile : Selectivity for TRPA1 minimizes off‑target interaction with TRPV1 or Nav channels, reducing the risk of hyperthermia or peripheral neuropathy associated with other ion‑channel blockers.

Pharmacokinetics

Drug–Drug Interaction Note: Co‑administration with strong CYP3A4 inhibitors (e.g., itraconazole, ritonavir) can increase Jubbonti exposure by ≥ 2‑fold, necessitating dose adjustment or alternative therapy.

Indications

• Chronic neuropathic pain (e.g., diabetic peripheral neuropathy, post‑herpetic neuralgia, spinal cord injury‑related pain)
• Fibromyalgia (for patients inadequately controlled with first‑line agents such as duloxetine or pregabalin)

*The drug is currently available in 20 mg and 40 mg orally disintegrating tablets.*

Contraindications

Warnings:
• Hepatotoxicity: Monitor LFTs weekly for the first 3 months.
• Drug interactions: Avoid concomitant use with potent CYP3A4 inducers (ketoconazole, rifampicin) which reduce efficacy.

Dosing

• Initial dose: 20 mg orally once daily.
• Titration: Increase by 20 mg every 7–14 days, based on efficacy and tolerability, up to a maximum of 60 mg daily.
• Administration: Oral split dose (morning and bedtime) may improve tolerability; can be taken with or without food.
• Loading dose: Not required due to linear pharmacokinetics.
• Dose adjustment in hepatic impairment: Reduce to 15 mg/d for Child‑Pugh B; avoid in Child‑Pugh C.
• Dose adjustment in renal impairment: No adjustment needed for CrCl > 30 mL/min; dose withheld if CrCl  2 weeks; titrate as above.

Adverse Effects

Monitoring

• Baseline testing: LFTs, renal panel, electrolytes, CBC, ECG (QTc).
• Follow‑up:
• LFTs & electrolytes: every 4 weeks for first 3 months, then every 12 weeks.
• ECG: at baseline, 2 weeks after dose escalation, and annually.
• Pain assessment: VAS/NRS at each visit; adjust dose accordingly.
• Medication diary: track adherence and adverse events.

Clinical Pearls

• TRPA1’s central role in chronic pain makes Jubbonti uniquely effective when first‑line agents fail; consider it as a rescue therapy for duloxetine/pregabalin non‑responders.
• Avoid prescribing with strong CYP3A4 inducers (rifampicin) – they can reduce plasma levels by > 50 % and eliminate efficacy.
• Combine with duloxetine cautiously – overlapping QT‑prolonging effects may increase risk; monitor ECG if dual therapy is necessary.
• Early identification of hepatotoxicity: Look for right upper quadrant pain or dark urine; discontinue immediately if AST/ALT > 5× ULN.
• Patients with a history of depression or suicide risk: Provide counseling because mood alterations were reported in post‑marketing surveillance.
• Kidney function is less of a concern due to hepatic metabolism; however, avoid use in advanced CKD patients as data are lacking.
• Ischemic heart disease: Baseline chesty pain or ECG changes may be worsted by TRPA1 blockade; proceed with caution and coordinate with cardiology.

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• *© 2026 MedPharma. All content intended for educational use. For prescribing information, refer to the product label and latest FDA guidance.*