Approved & therapeutic
Ziconotide
Prialt
Ziconotide is a synthetic version of a conotoxin from the venom of the marine cone snail Conus magus, approved for severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments. It must be given intrathecally.
Also known as: SNX-111, omega-conotoxin MVIIA
- Status
- Ziconotide is approved by the U.S. FDA and has official prescribing information.
- Evidence
- Approved labeling. Official prescribing information exists, based on clinical trials in people.
- Half-life
- Approximately 4.6 hours in cerebrospinal fluid.
- How it's taken
- Continuous intrathecal infusion via an implanted or external microinfusion device
- Mechanism
- Other
How Ziconotide works
Ziconotide selectively blocks N-type voltage-gated calcium channels on primary nociceptive afferents in the dorsal horn of the spinal cord. Blocking calcium entry prevents release of the neurotransmitters that propagate the pain signal. It is not an opioid, has no activity at opioid receptors, and does not produce tolerance or physical dependence.
What research has looked at
- A non-opioid mechanism, so it does not cause respiratory depression, tolerance or dependence, and can be used in patients who have exhausted opioid options.
- No withdrawal syndrome on abrupt discontinuation.
- Effective in some neuropathic pain states that respond poorly to opioids.
Evidence level: Approved labeling. Official prescribing information exists, based on clinical trials in people. These are areas studied or reported, not promised effects.
Reported side effects and risks
- Boxed warning for severe psychiatric symptoms and neurological impairment. Hallucinations, paranoid reactions, hostility, delirium, psychosis and suicidal ideation have occurred; the label directs discontinuation for evidence of cognitive impairment, hallucinations or mood changes.
- It is contraindicated in patients with a history of psychosis.
- It requires an implanted or external intrathecal delivery system, with the associated risks of meningitis and catheter complications.
- Creatine kinase elevations occur and should be monitored.
- Dizziness, nausea, confusion, nystagmus, ataxia and abnormal gait are frequent, and dose titration must be slow.
Sources
- FDA approved-drug listing for ziconotide · U.S. Food & Drug Administration
- DailyMed prescribing information for ziconotide · NIH · DailyMed
- PubMed research on ziconotide intrathecal N-type calcium · NIH · National Library of Medicine
- DrugBank record for ziconotide · DrugBank
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Related compounds
Ziconotide FAQ
What is Ziconotide?
Ziconotide is a synthetic version of a conotoxin from the venom of the marine cone snail Conus magus, approved for severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments. It must be given intrathecally.
How does Ziconotide work?
Ziconotide selectively blocks N-type voltage-gated calcium channels on primary nociceptive afferents in the dorsal horn of the spinal cord. Blocking calcium entry prevents release of the neurotransmitters that propagate the pain signal. It is not an opioid, has no activity at opioid receptors, and does not produce tolerance or physical dependence.
Is Ziconotide FDA approved?
Yes. Ziconotide is approved by the U.S. FDA and has official prescribing information. Evidence level: approved labeling. Official prescribing information exists, based on clinical trials in people.
What is the half-life of Ziconotide?
Reported half-life: Approximately 4.6 hours in cerebrospinal fluid.
How is Ziconotide taken?
Continuous intrathecal infusion via an implanted or external microinfusion device.
What side effects have been reported with Ziconotide?
Reported in the sources: Boxed warning for severe psychiatric symptoms and neurological impairment. Hallucinations, paranoid reactions, hostility, delirium, psychosis and suicidal ideation have occurred; the label directs discontinuation for evidence of cognitive impairment, hallucinations or mood changes; It is contraindicated in patients with a history of psychosis; It requires an implanted or external intrathecal delivery system, with the associated risks of meningitis and catheter complications; Creatine kinase elevations occur and should be monitored; Dizziness, nausea, confusion, nystagmus, ataxia and abnormal gait are frequent, and dose titration must be slow.
Educational summary compiled from the sources listed above. Not medical advice. Peptide Vault does not sell, source or recommend any compound. Talk to a qualified clinician before starting or changing anything.