Suzetrigine
Suzetrigine
Brand names:Suzetrigine
A non-opioid analgesic added to the TCCC Combat Wound Medication Pack in 2026 for mission-capable casualties with moderate to severe pain. Suzetrigine is a peripheral sodium channel blocker that does not depress respiratory drive or cause sedation.
Pharmacology and Actions
Suzetrigine selectively inhibits the Nav1.8 sodium channel, a voltage-gated sodium channel expressed primarily on peripheral pain-signaling neurons. By blocking signal transmission at the peripheral nerve level rather than acting centrally, suzetrigine produces analgesia without the sedation, respiratory depression, or cognitive impairment associated with opioid analgesics. The drug does not bind opioid receptors and does not produce dependence or tolerance in the way opioids do.
Indications
- Moderate to severe acute pain in mission-capable casualties (TCCC 2026)
- Component of the Combat Wound Medication Pack (CWMP)
- Acute pain management when opioid avoidance is preferred
Absolute Contraindications
- Known suzetrigine allergy
- Severe hepatic impairment (consult prescribing information)
Precautions and Side Effects
May cause headache, nausea, or itching
Hepatic monitoring may be indicated for prolonged use (consult prescribing information)
Drug interactions less extensive than opioids but still warrant review
Not a substitute for procedural sedation or analgesia in shock states
Adult Dosing
Take with the other CWMP components: acetaminophen 1000 to 1300 mg PO every 8 hours and meloxicam 15 mg PO once a day.
Onset: 30 minutes to 2 hours
Pharmacokinetics
Peak Effect: PO: 2 to 3 hours
Duration: PO: 8 to 12 hours
Storage and Handling
Store at controlled room temperature. Protect from moisture. No special handling requirements compared to other oral medications.
Suzetrigine is not a controlled substance. Standard medication storage and accountability apply.
Reconstitution:
Supplied as oral tablets. No reconstitution required.
TCCC and TECC Role
Suzetrigine is the operationally significant new analgesic in the 2026 TCCC update. The drug works on a different pain pathway than opioids and NSAIDs, which makes it useful in the field for two reasons. It does not depress respiration the way opioids do, and it does not carry the bleeding risk concerns that limit NSAID use in trauma.
The 2026 TCCC analgesia ladder uses suzetrigine alongside acetaminophen and meloxicam in the Combat Wound Medication Pack for casualties who are still mission capable. Casualties who cannot stay in the fight move to ketamine, administered by TCCC medical personnel.
The 2026 TCCC update removed OTFC and the prior fentanyl-first options from the primary analgesia ladder. Suzetrigine fills part of the gap created by that removal. Opioids remain in the polypharmacy warnings but are not lead agents in the 2026 algorithm.
Suzetrigine is the operationally significant new analgesic in the 2026 TCCC update. The drug works on a different pain pathway than opioids and NSAIDs, which makes it useful in the field for two reasons. It does not depress respiration the way opioids do, and it does not carry the bleeding risk concerns that limit NSAID use in trauma.
The 2026 TCCC analgesia ladder uses suzetrigine alongside acetaminophen and meloxicam in the Combat Wound Medication Pack for casualties who are still mission capable. Casualties who cannot stay in the fight move to ketamine, administered by TCCC medical personnel.
For civilian providers, suzetrigine availability and scope-of-practice authorization will lag the military adoption. Watch for it to enter civilian tactical and EMS protocols as state EMS offices and medical directors evaluate the evidence.
Treating suzetrigine as interchangeable with opioids in pain ladders. The clinical profile and indications are different. Suzetrigine is for mission-capable analgesia. It is not a substitute for ketamine in shock or for procedural sedation needs.
This drug profile is provided as educational reference material for trained medical providers. It is not medical advice, not a substitute for formal training, and not a substitute for current published guidelines or medical direction.
Drug administration is governed by your scope of practice, agency standing orders, medical director protocols, and applicable state and federal regulations. Controlled substances are subject to additional handling, accountability, and documentation requirements per DEA and state law. Always verify dosing, indications, contraindications, and route of administration against current published guidelines and your local protocols before administration.
If this content is being viewed during a medical emergency, call 911 immediately and follow the direction of your local emergency dispatch and medical control. Do not use this reference as a substitute for emergency medical services.
Drug information evolves. Last reviewed dates and source citations are provided for each entry. Confirm currency against the cited source before clinical use.
Penn Tactical Solutions publishes this reference for educational purposes. PTS does not provide medical direction and does not assume responsibility for clinical decisions made in the field. Clinical responsibility rests with the administering provider, their medical director, and their agency.
Educational reference for trained medical providers. Not medical advice. Not a substitute for formal training, current published guidelines, or medical direction. Drug administration is governed by your scope of practice, agency standing orders, medical director protocols, and applicable state and federal regulations. Controlled substances require additional storage, accountability, and documentation per DEA and state law.
In a medical emergency, call 911. This reference is not a substitute for emergency medical services.
Verify dosing, indications, and contraindications against current published guidelines and your local protocols before administration. Confirm content currency against the source citation. Penn Tactical Solutions does not provide medical direction. Clinical responsibility rests with the administering provider, their medical director, and their agency.
Suzetrigine
| PO | TCCC 2026 (CWMP): 100 mg PO once (administered as two 50 mg tablets), then 50 mg PO every 12 hours Take with the other CWMP components: acetaminophen 1000 to 1300 mg PO every 8 hours and meloxicam 15 mg PO once a day. (30 minutes to 2 hours) |