Suzetrigine received Food and Drug Administration (FDA) approval on January 30, 2025, for the treatment of moderate-to-severe acute pain in adults.¹ As the first new non-opioid acute pain medication in more than two decades, suzetrigine has been positioned as a potential alternative to opioids in clinical situations where opioids would historically have been considered.²,³ Because suzetrigine does not act on opioid receptors, it is thought to carry little risk of dependence or respiratory depression, which has prompted interest in whether and how clinicians might use it in place of opioids. However, the medication is newly available, little is known about the real-world patterns of suzetrigine prescribing, including which clinical specialties are adopting it, which patient populations are receiving it, and for which indications it is being prescribed relative to the opioids it might replace. Understanding these early prescribing patterns helps characterize how a new pain medication enters clinical practice and where its use diverges from its labeled indication.
We studied more than 3.6 million U.S. adults aged 18 and older who received a prescription for either suzetrigine or an opioid between February 2025 and April 2026. Patients were excluded if they had received either medication in the 30 days before the index prescription, if both medications were prescribed at the same visit, or if they did not have a pain score documented on the day before or day of the prescription.
Suzetrigine and opioids have been prescribed for substantially different clinical indications in the first 15 months following suzetrigine’s approval, as seen in Figure 1. Chronic pain accounted for 33.0% of suzetrigine prescriptions, but only 6.7% of opioid prescriptions. Opioid prescribing was concentrated in encounters for surgery (48.8%) and acute pain (19.8%), which together accounted for 68.6% of opioid prescriptions but only 42.0% of suzetrigine prescriptions.
The specialty mix reinforces this pattern. Pain medicine and orthopedic surgery together wrote 40.9% of suzetrigine prescriptions but only 3.5% of opioid prescriptions. Conversely, emergency medicine and general surgery wrote 64.1% of opioid prescriptions but only 20.8% of suzetrigine prescriptions. Suzetrigine adoption has been concentrated in specialties that manage chronic and surgical pain longitudinally rather than in the acute-care settings where opioids are most commonly initiated.
Patient demographics also showed differences in prescribing patterns. Adults aged 65 and older made up 43.0% of suzetrigine recipients versus 31.4% of opioid recipients, and female patients made up 63.1% of suzetrigine recipients versus 57.2% of opioid recipients. Differences by race and ethnicity were smaller.
