Novel pain medication for the “Paindemic”

Tens of millions of people in the US deal with significant acute and chronic pain every day – we have a “paindemic.” Novel pain medications, especially non-opioid drugs, are needed to help address the paindemic here and around the world. The FDA has just approved suzetrigine (trade name Journavx), the first drug to emerge in this exciting new class of pharmaceuticals for pain relief, or analgesia (https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain). What is so novel and fascinating about this new pain medication?

First, let’s look at how nerve fibers work, including those that transmit pain signals. When a pain receptor is stimulated by a painful stimulus, e.g. heat, sodium ions enter the cell through pores in cell membranes called sodium channels. As sodium enters the nerve cell through these sodium channels, a change in the electric charge inside the membrane occurs. This membrane “depolarization” causes an electric signal to travel along the nerve to areas in the brain that register pain. This is how we feel pain when we touch a hot stove. 

Most pain medications, including opioids, work mainly in the brain. The side effects of opioids are largely due to the activation or suppression of receptors in the brain that are unintended targets. For example, nausea and vomiting receptors in the brain are activated, while respiratory centers are suppressed. The latter effect may be lethal. The euphoria caused by opioids relates to pleasure centers in the brain and is largely responsible for addiction to these drugs. 

Non-opioid analgesic drugs, such as aspirin, ibuprofen, and acetaminophen, also largely work in the brain. They do not, in general, prevent pain impulses from reaching the brain from pain receptors in the skin and other areas of the body.

Suzetrigine is one of a number of exciting new non-opioid analgesia drug that have been in development (https://link.springer.com/article/10.1007/s40265-024-02118-0). Suzetrigine works at very specific sodium channels outside the brain, i.e. at the source of the pain (https://pubmed.ncbi.nlm.nih.gov/39775738/). There is a decrease in depolarization at the level of the pain receptor, e.g. a heat receptor in the skin. Suzetrigine appears to cause little or no effect in the brain, and appears to lack dreaded side effects such as depression of breathing. Other side effects associated with opioids and non-opioid analgesia drugs, such as nausea, vomiting, and risk of bleeding, do not occur with suzetrigine.

Suzetrigine, a newly approved, novel, non-opioid analgesic drug, holds the promise to help millions of people afflicted in the current paindemic!

Note: Although I am a physician, the content in this article is not meant to diagnose, treat, cure or prevent illness or disease in the reader – it is for educational purposes only.

References

1. FDA approves novel non-opioid treatment for moderate to severe acute pain, https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain, 4Feb2025.
2. Osteen JD, Immani S, Tapley TL, et al. Pharmacology and Mechanism of Action of Suzetrigine, a Potent and Selective NaV1.8 Pain Signal Inhibitor for the Treatment of Moderate to Severe Pain. Pain Ther 2025, doi. org/ 10. 1007/ s40122- 024- 00697-0,  https://pubmed.ncbi.nlm.nih.gov/39775738/
3. Oliver B, Devitt C, Park G, et. al. Drugs in Development to Manage Acute Pain. Drugs 2025;85(1):11-19, https://link.springer.com/article/10.1007/s40265-024-02118-0