Suzetrigine: A New and Novel Analgesic for Acute Pain.

OBJECTIVES: Suzetrigine (Journavx), from a new class of non-opioid analgesics, is the first approved agent indicated for adults with moderate to severe pain in almost 3 decades. Reviewed are the drug's unique pharmacology, history of development, clinical evidence of safety and effectiveness, with an emphasis on implications for nursing practice. Literature describing the basic pharmacology as well as the results from extant clinical trials are integrated in this narrative educational review.

FINDINGS: Suzetrigine provides analgesia by blocking a specific sodium channel on peripheral nociceptors, interrupting pain signal transmission before reaching the central nervous system. In the clinical trials underlying Food and Drug Administration approval, 50 mg of suzetrigine (following a 100 mg loading dose) was demonstrated to be as effective as 5/325 mg hydrocodone/acetaminophen in patients undergoing bunionectomy or abdominoplasty and better tolerated. In subsequent open-label studies, 83%-91% of patients with diverse surgical and non-surgical conditions who received suzetrigine for up to 14 days rated analgesia as good to excellent, with few requiring rescue opioids. Currently, suzetrigine is approved only for acute pain, with ongoing trials evaluating its use for chronic pain conditions.

NURSING PRACTICE IMPLICATIONS: Concomitant medications must be carefully assessed as CPY3A inhibitors or inducers can change dosing requirements or even contraindicate use. The medication must be taken orally, with the loading dose on an empty stomach. Analgesia should be assessed within 2 to 4 hours and inadequate relief supplemented with multimodal pharmacotherapy including opioids. Suzetrigine may require prior authorization which should be considered prior to discharge.