Suzetrigine (Journavx) for Hospice Pain Management: A Promising Advancement or Too Early to Tell? - OnePoint Patient Care

April 14, 2025

Suzetrigine (Journavx) for Hospice Pain Management: A Promising Advancement or Too Early to Tell?

In light of the ongoing opioid crisis, there’s been a significant push to develop new medications for pain that have fewer side effects and lower risks of addiction and overdose. The highly anticipated approval of suzetrigine (trade name Journavx) in January 2025 marks the first time in over 20 years that a drug from a new class of pain medications gets the green light from the FDA. It’s no surprise that this opioid alternative is generating some buzz among patients and people in the medical community.

Suzetrigine is different from other pain medications. It doesn’t interact with mu-opioid receptors or other receptors in the central nervous system and hasn’t been associated with addiction, tolerance, or misuse.1,2 It prevents pain signals from reaching the brain by targeting specific voltage-gated sodium channels (NaV 1.8) in peripheral nerves.2

Suzetrigine chemical structure

Suzetrigine is well tolerated and adverse effects are primarily limited to infrequent reports of itching, muscle spasm, or rash.3,4 This is a major benefit over opioids which commonly cause sedation, constipation, and nausea and have the potential to cause clinically significant respiratory depression. It has an edge over pain relievers like NSAIDS, too, that can negatively affect kidney function, increase the risk for cardiac events, or cause serious gastrointestinal effects including ulceration and bleeding. Despite suzetrigine’s attractive safety profile thus far, we know that older patients don’t tolerate certain drugs as well as younger ones so it’s worth mentioning that it’s been studied in fewer than 100 older adults (<7% of patients in published trials) – this might warrant additional caution until there’s more data in older adults.4

Suzetrigine’s approval was based on trials showing improved efficacy and faster onset compared to placebo when used for post-operative pain after tummy tucks and bunionectomies; effects on pain were similar to hydrocodone/APAP.1,4 Notably, approval was limited to the treatment of acute pain and it hasn’t been evaluated for use longer than 14 days; studies for chronic pain conditions including neuropathic pain types are still underway. So it remains to be seen whether suzetrigine will be safe and effective for patients with different pain types or who have persistent or escalating pain for longer periods.

As a new-to-market, brand only drug, it should come as no surprise that suzetrigine costs significantly more than the other pain relievers that are readily available and regularly prescribed today. The average wholesale price for suzetrigine is $37 per day, or $520 for a 14-day course.3

Suzetrigine will appeal to both patients and clinicians interested in non-opioid alternatives for managing pain due to concerns for side effects, addiction, and misuse. This drug has the potential to change the pain management game, but there might be enough limitations to prevent widespread use in hospice and palliative care just yet.

Written by: OnePoint Patient Care Clinical Team

Joseph Solien, PharmD, BCGP, BCPP – Vice President of Clinical Services

Melissa Corak, PharmD, BCGP – Senior Clinical Pharmacist

John Corrigan, PharmD, BCGP – Clinical Pharmacist

References

  1. Bertoch T, et al. Suzetrigine, a Non-Opioid NaV1.8 Inhibitor for Treatment of Moderate-to-Severe Acute Pain: Two Phase 3 Randomized Clinical Trials. Anesthesiology. 2025 Mar 21. Link.
  2. Osteen J, 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 Apr;14(2):655-674. doi: 10.1007/s40122-024-00697-0.
  3. UpToDate Lexidrug. https://online.lexi.com/. Accessed April 4, 2025.
  4. JOURNAVX [prescribing information]. Vertex Pharmaceuticals Incorporated. Boston, MA; January 2025. Link