Suzetrigine, sold under the brand name Journavx, is an analgesic medication used in the treatment of moderate to severe acute pain. It is taken orally. Suzetrigine was developed by Vertex Pharmaceuticals.
The most common adverse effects include itching, muscle spasms, increased blood level of creatine phosphokinase, and rash.
Suzetrigine is a small-molecule non-opioid analgesic that works as a selective inhibitor of Nav1.8-dependent pain-signaling pathways in the peripheral nervous system. Nav1.8 channels are predominantly present in peripheral nociceptive neurons of the dorsal root ganglia. Suzetrigine inhibits pain signals before they reach the central nervous system and has no addictive potential.
Suzetrigine was approved for medical use in the United States in January 2025. The US Food and Drug Administration considers it to be a first-in-class medication.
Medical uses Suzetrigine is indicated for the treatment of moderate to severe acute pain in adults. It was primarily studied in people with postoperative pain, including due to abdominoplasty and bunionectomy. However, a small minority of patients received suzetrigine for non-surgical pain, including arthralgias, limb pain, and sprains and strains. Treatment of acute pain using suzetrigine has not been studied beyond 14 days of use.
In clinical studies conducted through 2024, suzetrigine reduced pain typically from 7 to 4 on the standard numeric scale used to rate pain. The efficacy of suzetrigine was evaluated in two randomized, double-blind, placebo- and active-controlled trials of acute surgical pain, one following abdominoplasty and the other following bunionectomy. Both trials found that suzetrigine reduced pain more effectively than placebo. Suzetrigine was not superior to placebo for the treatment of lumbosacral radiculopathy.
However, in clinical studies, no superiority over hydrocodone and paracetamol (acetaminophen) in terms of pain reduction was shown over 48 hours. Medical professionals have noted its efficacy may be inferior to high-dose opioid analgesics. There are no studies comparing suzetrigine with high-dose opioids. Suzetrigine exhibits CYP3A4-mediated drug interactions and there is limited long-term data regarding its use. Moreover, usage has not been studied in those younger than 18 or older than 80 years of age and its cost-effectiveness is disputed.
Contraindications Concomitant use of suzetrigine with strong CYP3A4 inhibitors is contraindicated.
Adverse effects The most common adverse effects of suzetrigine may include itching, rash, muscle spasms, and increased levels of creatine kinase. Mild side effects may include nausea, vomiting, constipation, headache, and dizziness. In preliminary research, suzetrigine had no serious neurological, behavioral, addictive, or cardiovascular effects.
long-term safety in broader contexts including multimodal analgesia, pregnancy and breastfeeding women remain undetermined.
Interactions Consuming grapefruit while using suzetrigine may cause adverse grapefruit–drug interactions.
Pharmacology Pharmacodynamics Suzetrigine operates on Nav1.8 channels predominately found in the peripheral nociceptive neurons of the dorsal root ganglia. This mechanism avoids the addictive potential of opioids caused by their effects on the reward system in the central nervous system. Unlike opioid medications, which reduce pain signals in the brain, suzetrigine works by closing sodium channels in peripheral nerves, inhibiting painful sensations from being transmitted to the brain.
In pharmacological studies, suzetrigine bound to the voltage-sensing domain 2 of Nav1.8 channels with a 3,100-times greater affinity than to other voltage-gated sodium channels. Suzetrigine selectively bound to this site on these sodium channels with a novel allosteric mechanism, thereby stabilizing the closed state and causing tonic inhibition.
Pharmacokinetics Suzetrigine is well-absorbed from the GI tract, with the 50mg maintenance dose being relatively unaffected by meal timing, and the 100mg initial dose requiring an empty stomach for proper absorption. Suzetrigine has a mean effective half-life of 23.6 hours and is 99% protein-bound; its active metabolite, M6-SUZ, has a mean effective half-life of 33 hours and is 96% protein-bound. Steady-state concentrations are reached within 3 days. The primary metabolic pathway is via CYP3A isozymes, followed by excretion via feces (49.9%) and urine (44%).
Suzetrigine may potentially interact with certain hormonal birth controls, resulting in reduced efficacy. During clinical trials, it was observed that the efficacy of levonorgestrel and ethinyl estradiol were not reduced by suzetrigine administration, and can be safely used together.
History Vertex Pharmaceuticals announced in January 2024 that suzetrigine had successfully met several endpoints in its phase III clinical trials. The company announced in July 2024 that the US Food and Drug Administration (FDA) had accepted a New Drug Application for suzetrigine. Due to its novel mechanism, the FDA granted priority review, fast track, and breakthrough therapy designations to the application for suzetrigine. In January 2025, the FDA granted approval of Journavx to Vertex Pharmaceuticals, making it the first non-opioid pain medication to be approved by the FDA in two decades.
As of November 2025, phase IV post-marketing clinical trials are underway to assess the effectiveness and safety of suzetrigine as a part of multimodal therapy for the treatment of acute post-operative pain.
The manufacturer engaged in lobbying activity promoting non-opioid pain treatment and supporting the NO PAIN Act (Non-Opioids Prevent Addiction In the Nation Act).
Society and culture Legal status Suzetrigine was approved for medical use in the United States in January 2025.
Names Suzetrigine is the international nonproprietary name.
Suzetrigine is sold under the brand name Journavx.
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