By Ed Sutton, MD
Suzetrigine, marketed as JOURNAVX by Vertex Pharmaceuticals, is the first new analgesic with a novel mechanism of action to be FDA approved in two decades.
As anesthesia providers, we need to have an understanding of this new mechanism of action, as similar molecules will likely be developed in the future.
Anesthesiology, June 1st, 2025, published two large randomized, double-blind, placebo-controlled studies involving abdominoplasty and bunionectomy. Suzetrigine was found to be as efficacious as hydrocodone/acetaminophen (Percocet) without the risk of severe side effects, misuse, or potential for addiction. Suzetrigine also has an excellent safety profile compared to other commonly used analgesics, including NSAIDs (bleeding and GI side effects), acetaminophen (liver toxicity), and gabapentinoids (dementia).
Suzetrigine inhibits the voltage-gated sodium channel NaV1.8, which is highly expressed in peripheral afferent nociceptors (pain fibers). This represents a completely new mechanism of action for an analgesic medication. Inhibiting NaV1.8 channels prevents action potentials from being transmitted from the periphery into the spinal cord, providing non-opioid pain relief comparable to hydrocodone. NaV1.8 channels have been extensively researched for more than 15 years, and suzetrigine acts selectively at this site without interfering with other sodium-gated channels. The gene encoding NaV1.8, SCN10A, is currently being studied through loss-of-function and gain-of-function mutations to better understand chronic pain conditions and explore future pharmacogenetic therapies.
As anesthesia providers, it is important to understand pain control pharmacology, including modulation of the NaV1.8 channel (at least for board examinations). Suzetrigine represents an exciting expansion in pain control science, and JOURNAVX is the first drug in this new class of analgesics. To reduce confusion and medication errors, the FDA now provides final approval of all trade names for new drugs. While companies rarely explain name origins, Vertex Pharmaceuticals may have selected JOURNAVX to suggest a “new day” (Jour) for pain management via NaV1.8 blockade. Ideally, future drugs in this class will include “NAV” in their names to aid recognition.
