Generic Name

Suzetrigine

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Classification

FDA Approved Indications

• Major depressive disorder
• Generalized anxiety disorder (if approved)

Mechanism of Action

Suzetrigine inhibits the reuptake of serotonin and norepinephrine, increasing their levels in the synaptic cleft, which helps improve mood and reduce anxiety.

Dosage and Administration

Adult: Typically 50-100 mg once daily, titrated as needed.

Pediatric: Not approved for pediatric use.

Geriatric: Start at lower doses due to increased sensitivity to side effects.

Renal Impairment: Adjust dose accordingly, beginning with lower doses.

Hepatic Impairment: Use caution; may require dose adjustment.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Wide distribution including CNS.

Metabolism: Metabolized in the liver, primarily by CYP450 enzymes.

Excretion: Excreted mainly via urine and feces.

Half Life: Approximately 12 hours.

Contraindications

• Known hypersensitivity to Suzetrigine or components.
• Concurrent use with monoamine oxidase inhibitors (MAOIs).

Precautions

• Use with caution in patients with a history of suicidal ideation, especially during initial therapy.
• Monitor for changes in mood or behavior.

Adverse Reactions - Common

• Nausea (Common)
• Drowsiness (Common)
• Dry mouth (Common)

Adverse Reactions - Serious

• Serotonin syndrome (Rare)
• Increased blood pressure (Uncommon)
• Suicidal thoughts or behaviors (Monitor closely, especially in young adults and adolescents.)

Drug-Drug Interactions

• Serotonergic agents (e.g., SSRIs, SNRIs, triptans)
• MAOIs

Drug-Food Interactions

• Limit alcohol intake.
• Avoid grapefruit juice which may alter metabolism.

Drug-Herb Interactions

• St. John's Wort (risk of serotonin syndrome)

Nursing Implications

Patient/Family Teaching

• Do not discontinue abruptly.
• Report unusual changes in mood, behavior, or thoughts.
• Avoid alcohol and hazardous activities until stabilized.

Special Considerations

Black Box Warnings:

• Increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults

Genetic Factors: Genetic variations in CYP2D6 may affect metabolism.

Lab Test Interference: May affect blood pressure readings.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, tremor, agitation, somnolence, seizures.

Treatment: Supportive care, activated charcoal if early, seizure management, and monitoring in a medical setting.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.