Novel pain medication suzetrigine (JOURNAVX) - is it similar to lamotrigine?

Jason Cafer MD

12 minutes ago2 min read

Generic name: Suzetrigine

Trade name: JOURNAVX

Year of FDA approval: 2025

Pronunciation: soo-ZEH-tri-jeen / jor-NAV-ix

Mnemonic phrase: “Suzy, try Journalism”

FDA-approved for: Moderate to severe acute pain

Mechanism:

❖ Nav1.8 sodium channel blocker

❖ Novel non-opioid analgesic

Importance: Likely groundbreaking

Cost: As a first-in-class medication approved for short-term use, it will be expensive

Suzetrigine JOURNAVX mnemonic, medication mascot by Jason Cafer MD

Is suzetrigine similar to lamotrigine?

No. Suzetrigine is distinct from lamotrigine. The "-trigine" suffix is coincidental, not indicative of a shared drug class. Suzetrigine selectively targets NaV1.8 sodium channels for pain relief, while lamotrigine has broader effects on sodium channels and other receptors.

Chemical structures of lamotrigine and suzetrigine, "The -trigines are unrelated by Jason Cafer MD - Is there a -trigine drug class?

Mechanism

Suzetrigine inhibits pain signal transmission in the peripheral nervous system by selectively blocking NaV1.8 sodium channels.

Structure (for mnemonic purposes) of voltage-gated sodium channel, ions, Jason Cafer MD

Diagram explaining voltage-gated sodium channels, with drugs listed as blockers for Na+ channels 1.1-1.8. Nav explanation and what medications block Nav channels, ballicule

Is suzetrigine a candidate for psychiatric repurposing?

Unlikely. Nav1.8 is primarily known for its expression in peripheral sensory neurons, particularly dorsal root ganglia (DRG) neurons, where it plays a key role in pain signaling. Its presence in most brain regions is very low or undetectable.

Does suzetrigine have psychiatric side effects?

Unlikely

Efficacy

Reduces pain from 7 to 4 on a 0-10 scale, comparable to hydrocodone + acetaminophen

Duration of Treatment

Not studied beyond 14 days

Most common side effects

❖ Pruritus

❖ Rash

❖ Muscle spasms

❖ Increased creatine phosphokinase

Dosing

Initial dose: 100 mg once, then 50 mg every 12 hours. First dose on empty stomach; subsequent doses with or without food. For moderate hepatic impairment or with moderate CYP3A4 inhibitors: Same initial dosing, then 50 mg every 24 hours from dose #5 onward

Pharmacokinetic interactions

❖ Sensitive CYP3A4 substrate (fish)

➤ Contraindicated with strong CYP3A4 inHibitors

➤ Dosage reduction required with moderate CYP3A4 inHibitors

❖ CYP3A4 inDucer (weak)

➤ May reduce efficacy of sensitive CYP3A4 substrates where minor concentration changes are significant.

– combined oral contraceptives, although those containing ethinyl estradiol with levonorgestrel or norethindrone are not affected

– alternatives to affected contraception recommended during treatment and for 28 days after discontinuation (because reversal of inDuction is Delayed)