Suzetrigine and the emergence of selective NaV1.8 inhibition in acute pain pharmacotherapy: efficacy, safety, and future clinical positioning
Abstract
ABSTRACT Introduction Acute pain remains a major clinical problem worldwide across postoperative and other acute-care settings, yet current therapies are often limited by inadequate efficacy, opioid-related risks, central nervous system adverse effects, or gastrointestinal, renal, and hepatic toxicity associated with conventional non-opioid analgesics. Suzetrigine (Journavx) is a first-in-class, non-opioid sodium channel blocker approved for moderate-to-severe acute pain in adults, with pivotal evidence from postoperative pain models, introducing selective NaV1.8 inhibition as a novel pharmacologic strategy in acute pain management. Areas covered This review evaluates the mechanistic rationale, clinical pharmacology, efficacy, safety, and likely therapeutic positioning of suzetrigine. Particular emphasis is placed on its selective peripheral analgesic mechanism, short-course oral dosing strategy, and pivotal randomized postoperative pain trials following full abdominoplasty and bunionectomy. The review also considers analgesic magnitude, onset of pain relief, active-comparator interpretation, CYP3A-mediated interactions, hepatic-impairment precautions, duration-of-use limits, and the potential role of suzetrigine within opioid-sparing and multimodal analgesic strategies. Expert opinion Suzetrigine is important less as a replacement for existing therapies than as a new peripheral, non-opioid analgesic pathway. Its long-term clinical value will depend on comparative…
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