Suzetrigine

Aka: Suzetrigine, Journavx

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II. Indications

  1. Moderate to severe acute pain in adults

III. Contraindications

  1. Severe hepatic Impairment (Child-Pugh Class C)
    1. Reduce dose in moderate hepatic Impairment

IV. Mechanism

  1. Non-Opioid Analgesic with unique mechanism, released in 2024 at $15/pill
  2. Sodium Channel Blocker developed for use in acute pain
    1. Specific for the voltage-gated Sodium channel Nav1.8 (SNS)
    2. Nav1.8 is found primarily in nociceptive Neurons (primarily in the dorsal root Ganglion)
    3. Blocks transmission of Peripheral Nerve pain sesnsation

V. Dosing

  1. First Dose: 100 mg orally on an empty Stomach (except clear liquids)
    1. May be taken with clear liquids (water, apple juice, tea or black coffee)
    2. First dose should be taken >1 hour before or >2 hours after food
  2. Subsequent Doses: 50 mg orally every 12 hours
    1. May be taken with or without food
    2. May be used for up to 14 days (longer courses have not been studied)

VI. Adverse Effects

  1. Pruritus
  2. Rash
  3. Myalgias and Muscle spasms
    1. May be associated with increased Creatine Phosphokinase (CPK)

VII. Safety

  1. Avoid in pregnancy (unknown safety)
  2. Avoid in Lactation (present in animal milk, unknown safety)

VIII. Drug Interactions

  1. CYP3A Inhibitors
    1. Avoid with use of strong CYP3A Inhibitors (e.g. Itraconazole)
    2. Avoid Grapefruit juice while on Suzetrigine
  2. CYP3A Inducers
    1. Avoid with moderate to strong CYP3A Inducers (e.g. Rifampin)
  3. Progestins (other than Levonorgestrel or Norethindrone)
    1. If used for Contraception, use an alternate contracepive while taking Suzetrigine and for 28 days after

IX. Efficacy

  1. Initial studies were with <1000 middle aged white women post-op (e.g. Bunion surgery, Abdominoplasty)
  2. Limited broader efficacy data, with FDA approval in early 2025
  3. Very expensive ($15/dose in 2025) for a medication with efficacy likely similar to Vicodin

X. Resources

  1. Suzetrigine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f0976da4-1d20-4517-945c-b60ed2f41c12

XI. References

  1. (2025) Presc Insights, Issue 3/2025
  2. LoVecchio (2025) Crit Dec Emerg Med 39(7): 34

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