Prescriptions for the new non-opioid pain medication suzetrigine more than doubled between April and August 2025, according to analysis from Epic Research. The increase indicates a growing interest in opioid alternatives for acute pain, even as clinicians grapple with how and where the drug best fits in practice.
The US FDA approved suzetrigine, marked as Journavx by Vertex Pharmaceuticals, in February 2025 for moderate-to-severe acute pain.
About 11% of all new prescriptions for the drug between February and August were written in April — roughly 2350 orders — compared with 28% in August, which saw roughly 6000 scripts, indicating an acceleration in prescribing, according to the researchers.
More than half of the 21,386 prescriptions for suzetrigine since the FDA approved the drug were written between July and August. Over the same period, opioid prescribing remained evenly distributed month to month, the analysis found. Orders for the non-opioid agent tended to be for more tablets than for opioids during the study period.
Suzetrigine blocks NaV1.8 sodium channels in peripheral sensory nerves, interrupting pain signals before they reach the central nervous system. Its mechanism of action is similar to but more selective than novocaine, which also inhibits sodium channels.
Unlike opioids, suzetrigine does not act in the brain and does not cause sedation or respiratory depression, features that have fueled enthusiasm among some clinicians wary of opioid-related harms. It also is marketed as being a nonaddictive alternative to opioid analgesics.
“It doesn’t work in the brain or the central nervous system, so it’s not going to cause sedation, it’s not going to impair someone’s function,” said Brett Stacey, MD, division chief of pain medicine and professor of anesthesiology and pain medicine at the University of Washington School of Medicine in Seattle. “It doesn’t seem to cause significant GI [gastrointestinal] side effects like constipation or nausea. So it’s a really low side-effect medication.”
As a result, he said, suzetrigine may be most useful for patients who are poor candidates for opioids.
“People who’ve had side effects with opioids previously, people at higher risk for opioid side effects — possibly elderly people — people who have a history of bad constipation or sedation or vomiting with opioids are perfect to think about this,” Stacey said.
Suzetrigine also may be useful for patients already taking opioids but are not receiving adequate pain relief, Stacey added. Previous research suggests the medication performs about as well as opioid combinations for acute pain, a meaningful benchmark for clinicians accustomed to the limited analgesic power of acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) alone.
“You can’t say that with Tylenol or ibuprofen,” Stacey said. “They can add to opioid analgesia, but they’re not going to completely replace opioids, whereas this has — if the dose is low — a chance to completely replace opioids.”
Variable Prescribing, Patient Response
This latest analysis offers only a partial picture of how and why use is rising since the study examined prescribing patterns, not clinical decision-making.
“The study was focused on patients prescribed suzetrigine, so we did not look at who is prescribing it,” said Kersten Bartelt, RN, of Epic Research, who helped conduct the analysis.
The analysis does not identify which specialties are driving the increase in prescribing. The data also doesn’t show how clinicians are using the drug — whether as a first-line option, a substitute for opioids, or an add-on to other pain therapies.
“We cannot determine whether suzetrigine was used as a first-line option, substitution for opioids, or as adjunct therapy,” Bartelt said.
One likely contributor, Stacey said, is clinicians’ long-standing desires for effective non-opioid options. However, for some patients, suzetrigine is not effective.
“I don’t think we can know who’s going to be a responder,” Stacey said. Because suzetrigine targets a specific pain pathway, he said, “some patients say, ‘Oh my gosh, this is the best thing we’ve ever tried for acute pain,’ and other patients say, ‘It doesn’t seem to do much.’”
That variability underscores the importance of early reassessment in primary care. Robert Chow, MD, MBA, assistant professor of anesthesiology at Yale University School of Medicine in New Haven, said clinicians should quickly evaluate whether the drug is delivering meaningful benefit.
“Clinicians should look for at least a two-point reduction in the numeric rating scale pain score, functional improvement, and a lack of adverse side effects” within the first 48-72 hours, Chow said, or consider a different form of analgesia.
Chow also cautioned against expanding use beyond what has been studied.
“The current evidence is limited to postoperative pain after abdominoplasties and bunionectomies, and thus its efficacy in treating other types of pain is unclear,” he said. “Its use should be limited to acute pain that is comparable to the scenarios that have been studied.”
He warned that suzetrigine may already be overused for neuropathic pain, where trials have shown limited benefit, and for mild acute pain that could be managed with NSAIDs or acetaminophen.
Cost, Coverage, Primary Care Barriers
Practical hurdles may also limit broader adoption in primary care. Cost and insurance coverage remain major hurdles — out-of-pocket costs can reach $500 for a 15-day supply. Insurance coverage often requires authorization, which can create delays in acute care.
Authorization appeals often succeed when clinicians document opioid intolerance, but that process can take time, Stacey said.
Stacey also cautioned that suzetrigine can reduce the effectiveness of oral contraceptives, something primary care clinicians should consider when prescribing.
Even with those limitations, Stacey described the drug as a meaningful — if incomplete — addition to pain management. Suzetrigine is approved for use for up to 2 weeks, although patients may only need it for a few days.
The clinicians said the drug should be viewed as part of a broader, multimodal approach rather than a replacement for other therapies.
“There’s no way it’s going to completely replace opioids,” Stacey said. “But it provides an alternative for the right patient.”
Stacey once received funding from Vertex, the maker of suzetregine, for a study involving a different drug. He reported having no additional disclosures. Chow reported having no relevant disclosures.
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