Ziconotide

FDA approved

Ziconotide (Prialt) is a 25-amino acid synthetic version of a cone snail toxin, approved by the FDA in 2004 for severe chronic pain. It is infused directly into the spinal fluid through an implanted pump.

At a glance

Where it acts: Brain & nerves
Regulatory status: FDA approvedApproved by the U.S. FDA for at least one medical use.

Mechanism of Action

Ziconotide blocks N-type voltage-gated calcium channels on pain-transmitting nerves in the spinal cord. This stops the release of pain neurotransmitters such as glutamate and substance P, without acting on opioid receptors.

Typical Dosage (Research)

Prescription-only medicine. Dosing is set by a physician according to the FDA-approved label and the condition being treated.

Side Effects & Risks

Dizziness, nausea, confusion, memory problems, abnormal gait and blurred vision.

Severe psychiatric symptoms and neurological impairment (boxed warning), including hallucinations, depression and suicidality. Contraindicated with a history of psychosis. Infection risk from the pump system.

Who Uses Ziconotide

Adults with severe chronic pain who need intrathecal therapy and cannot tolerate or no longer respond to other treatments.