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Generic Name: Ziconotide [zye-KON-oh-tide]
Name of the Brand: Prialt
Dosage Formula: Intrathecal solution (100 mg/mL, 25 mcg/mL)
The Class of Drug: miscellaneous analgesics

What is Ziconotide?

Ziconotide can be described as a non-narcotic pain reliever that works by blocking pain signals that come from nerves that go to the brain.

Ziconotide injections are administered via intrathecal injection to treat chronic pain patients who are unable to take or don't respond to standard pain relievers.Ziconotide is not a drug to be used for IV (intravenous) usage.


Certain users of ziconotide have experienced recent or worsening mental health issues. Talk to your doctor immediately if you notice any unusual changes in mood or behavior.It is not recommended to take this medication if you suffer from bleeding disorders that are not controlled, an issue affecting the spinal cord, or a past history of psychosis.

Ziconotide is only available via intrathecal injection using an infusion pump. It is not to be directly injected into a vein or another organ. Your physician, nurse, or another healthcare professional will administer the injection.Your doctor may alter the dose or flow rate in order to ensure that you get the most benefit from this medication.

Talk to your doctor if medicine is not functioning as well as relieving the discomfort. Inform your doctor if you frequently take other medications that cause sleepiness. Ziconotide may cause the sleepiness that is caused by these other drugs.

Consult your physician immediately in the event of an adverse reaction that is serious, such as neck stiffness, fever, seizures (convulsions), excessive drowsiness, fatigue, disorientation, confusion, hallucinations, thoughts of hurting yourself, or a decrease in consciousness.

Before you take this drug

It is not recommended to treat ziconotide if you are allergic to it or if you suffer from

  • Untreated or uncontrolled bleeding disorder untreated or uncontrolled bleeding disorder
  • A spinal issue (such as bone disorder, arthritis, or narrowing of the canal of the spinal).

Certain people who take ziconotide may have developed more or worsening mental issues. It is not recommended to treat with this medication if you are a victim of psychosis (delusions or a loss of connection to reality).

Speak to your doctor if you were recently prescribed opioids.Consult your physician if you are expecting or planning to become pregnant.It is not recommended to breastfeed while taking ziconotide.

Similar/related drugs

aspirin, acetaminophen, tramadol, duloxetine, naproxen, oxycodone, and tylenol

How to take Ziconotide?

Ziconotide is administered around the clock by using an infusion pump connected to a tube that is inserted into the area within your spine (intrathecal injection). The infusion device can be surgically implanted in your body or placed around your body. The pump regulates the speed at which the medication is delivered to your body.

Ziconotide can affect your thinking, speech, memory, or daily activities. The effects may begin slowly after using the medication for a few weeks. The doctor might alter the dosage or your pump's flow rate.Ziconotide doses are determined by weight. Your dose needs may change if you gain or lose weight.

Inform your doctor if the medication seems to be unable to relieve your pain or if your infusion pump isn't working correctly.If your catheter is damaged, you could get an infection. Consult your doctor immediately if you notice symptoms like headache, fever, migraine, neck stiffness, confusion, nausea, or vomiting.

If you are also using opioid pain medications, don't stop using the medication suddenly, or you might experience painful withdrawal signs. Discuss with your doctor the best way to stop using opioid pain medication.It is possible that you will need to take this medication for a period of time, which could be many years.Your doctor should monitor your health frequently.

What happens if I miss a dose?

Because your infusion pump's programming regulates your dose, you're not likely to skip a dose.

What happens if I overdose?

Get medical attention in an emergency or contact the Poison Help line toll-free at 1-800-222-1222.

The signs of a drug overdose could include anxiety or drowsiness. It could also cause vision issues, problems with speech, stiffness in your back or neck, nausea and vomiting, or loss of consciousness.

Avoid this

Avoid driving or engaging in hazardous activities until you are aware of the effects this medication will have on your body. The way you react could be impaired.Beware of drinking alcohol.

Side effects of Ziconotide

See a doctor immediately. Get medical attention immediately if you show symptoms that indicate an allergy reaction with ziconotide: hives, breathing difficulties, or swelling of your lips, face, or tongue.

Ziconotide may affect the central nervous system, which means you may experience a decrease in alertness. Someone who is caring for you must seek urgent medical treatment if you're struggling to get back up.

Contact your doctor immediately. If you suffer from:

  • Muscle pain that is getting worse or new and/or weakness, as well as soreness or dark urine;
  • A feeling of lightheadedness (like it's possible to pass out);
  • Strange sensations inside your mouth.
  • The skin, sores or itching blisters, and breaking of the skin's outer layer;
  • Confusion (especially among confusion (especially in);
  • Difficulties with memory or thought;
  • Strange change in behavior or mood—anger or aggression, paranoia, racing thoughts, hallucinations, taking risks;
  • Signs indicators signs of: feelings of self-worth devaluation, feelings of low self-esteem, a loss of interest in activities that you previously enjoyed or did, sleep-related issues or thoughts of hurting yourself,
  • Symptoms of meningitis—fever, headache, stiff neck—symptoms of meningitis include headache, neck stiffness, fever, increased sensitivity to light, nausea and vomiting, confusion, or fatigue.

Common ziconotide side effects may include:

  • Dizziness;
  • Confusion;
  • Nausea;
  • Abnormal or irregular eye movements.

This isn't an exhaustive list of possible side effects, and other effects may also be present. Consult your doctor for medical advice regarding adverse reactions. It is possible to report any adverse reaction to FDA by calling 1-800-FDA-1088.

Details on dosage

Usual Adult Dose for Chronic Pain:

Initial dose: 0.1 mcg/hr (2.4 mcg/day) via intrathecal device
Tirate doses in steps of as high as 2.4 mg/day over intervals not exceeding 2 to 3 times per week, depending on analgesic responses and adverse incidents; adjust the pump's infusion flow rate according to the need to obtain a new dose.
Maximum dose: 19.2 mcg/day (0.8 mcg/hr).
The administration should be under the supervision of a doctor who is experienced in the art of intrathecal administration and familiar with medication and the device's labeling.
The drug is indicated to be administered intravenously using the Medtronic SynchroMed(R) II Infusion System and the CADD-Micro Ambulatory Infusion Pump; refer to the manufacturer's manual for detailed instructions and tips to program the microinfusion device and/or refill the reservoir.
Use: To treat severe chronic pain in adults for whom the need for intrathecal therapy is justified and who are intolerant of or resistant to alternative treatments like general analgesics, adjunctive therapies, or intrathecal opioids.

Interaction with other drugs

Utilizing ziconotide in conjunction with other medications that cause you to become drowsy could cause more harm. Consult your physician before taking opioid medication, a sleep pill, a muscle relaxer, or medication for anxiety and seizures.

Discuss with your doctor any other medications you take, particularly:

  • Diuretic, also known as a "water pill";
  • Seizure medicine;
  • Medication to treat mood disorders or mental illnesses like schizophrenia.

This list isn't comprehensive. Other drugs can be incompatible with ziconotide, such as medications that are prescribed and available over the counter, vitamins, and herbal products. Some interactions with drugs are not listed here. are listed here.