Suzetrigine (Journavx) for Acute Dental Pain: First Clinical Case Series of a Selective Naᵥ1.8 Inhibitor in Endodontics
Abstract
INTRODUCTION
Emergency dental pain remains a significant clinical challenge, with many patients experiencing moderate-to-severe pain that is inadequately controlled by NSAIDs and acetaminophen. This is compounded by high rates of anesthetic failure in dental practices for cases with symptomatic irreversible pulpitis. Inflammation-driven upregulation of Naᵥ1.8 sodium channels contributes to persistent nociceptive signaling and local anesthetic failure. Suzetrigine (Journavx), a first-in-class selective Naᵥ1.8 inhibitor approved for acute moderate to severe pain, offers a mechanism-based approach by targeting the peripheral sodium channel driving inflammatory dental pain.
METHODS
This case series describes four patients treated at endodontic specialty practices who received suzetrigine for distinct acute pain scenarios: (1) augmentation of local anesthesia in a patient with symptomatic irreversible pulpitis and prior anesthetic failure, (2) management of pre-operative emergency dental pain in a patient with symptomatic irreversible pulpitis refractory to conventional analgesics, (3) control of post-treatment inflammatory flare-up pain inadequately managed by NSAIDs and corticosteroids, and (4) management of post-surgical pain in a medically complex patient with Ehlers-Danlos syndrome for whom non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids were contraindicated. Suzetrigine was prescribed as a 100 mg oral loading dose followed by 50 mg every 12 hours as…
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