JOURNAVX® (SUZETRIGINE), NEW PAIN MED WITH A NOVEL MECHANISM
Journavx® is the first pain medication with a novel mechanism approved in more than 20 years
Straight Healthcare
March 2025
March 2025
The FDA recently approved Journavx® (suzetrigine), a novel pain medication with a unique mechanism of action. Suzetrigine is a sodium channel blocker that selectively inhibits NaV1.8 voltage-gated sodium channels, which are expressed in peripheral sensory neurons involved in pain signaling. In a study of 1,118 patients undergoing abdominoplasty, suzetrigine demonstrated similar pain relief to hydrocodone/acetaminophen (5 mg/325 mg every 6 hours) over the first 48 postoperative hours. However, a separate similar study involving 1073 bunionectomy patients found suzetrigine to be superior to placebo but inferior to hydrocodone/APAP.
Suzetrigine's side effect profile is comparable to placebo, and no significant precautions have been identified. The recommended dosage is 100 mg once (on an empty stomach), followed 12 hours later by 50 mg every 12 hours (with or without food). Its use has not been studied beyond 14 days. Suzetrigine is a CYP3A substrate and inducer and should not be administered with strong CYP3A inhibitors. A notable interaction exists with hormonal contraceptives containing progestins other than levonorgestrel and norethindrone. The prescribing information advises that women taking these medications should use additional nonhormonal (e.g., condoms) or alternative contraceptives (e.g., combined oral contraceptives containing levonorgestrel or norethindrone) during treatment and for 28 days after discontinuation.
A novel, non-opioid pain reliever is a significant and much-needed addition. However, like all newly approved drugs, it is expensive and will likely face pushback from insurers. A study comparing it to a high-dose or potent NSAID, such as ketorolac, would be informative.
Suzetrigine's side effect profile is comparable to placebo, and no significant precautions have been identified. The recommended dosage is 100 mg once (on an empty stomach), followed 12 hours later by 50 mg every 12 hours (with or without food). Its use has not been studied beyond 14 days. Suzetrigine is a CYP3A substrate and inducer and should not be administered with strong CYP3A inhibitors. A notable interaction exists with hormonal contraceptives containing progestins other than levonorgestrel and norethindrone. The prescribing information advises that women taking these medications should use additional nonhormonal (e.g., condoms) or alternative contraceptives (e.g., combined oral contraceptives containing levonorgestrel or norethindrone) during treatment and for 28 days after discontinuation.
A novel, non-opioid pain reliever is a significant and much-needed addition. However, like all newly approved drugs, it is expensive and will likely face pushback from insurers. A study comparing it to a high-dose or potent NSAID, such as ketorolac, would be informative.
