Scientific intelligence record
Experience 2.0
Conotoxin-derived peptide
Ziconotide is a conotoxin-derived peptide studied for pain through N-type calcium-channel modulation. Evidence for a defined clinical preparation and route must be separated from broad conotoxin research and animal experiments.
Record status
Traceability partial
Last meaningful update: 9/23/2026
Ranked research corpus
399
Categorized publications with transparent machine-proposed ranking; human appraisal pending.
global evidence atlas
This is a deduplicated literature screening registry—not a claim that every mention directly proves efficacy or safety. Machine proposals remain visibly separate from governed human appraisal.
399 matching records · ranked 2026-09-18
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Europe PMC · 2026 · PMID 42304757 · DOI 10.1039/d6an00324a
preclinical-animal
Europe PMC · 2026 · PMID 42242129 · DOI 10.1016/j.chroma.2026.467160
preclinical-animal
Europe PMC · 2026 · PMID 42193237 · DOI 10.3390/antiox15050615
preclinical-animal
Europe PMC · 2026 · PMID 42227528 · DOI 10.2174/0109298673421752260407115756
human-interventional
Europe PMC · 2026 · PMID 42656698 · DOI 10.3389/fphar.2026.1863016
preclinical-animal
Europe PMC · 2026 · PMID 41888060 · DOI 10.24272/j.issn.2095-8137.2025.553
preclinical-animal
Europe PMC · 2026 · PMID 41910723 · DOI 10.1007/s00213-026-07053-4
preclinical-animal
Europe PMC · 2026 · PMID 42548796 · DOI 10.1155/cria/9977830
preclinical-animal
Europe PMC · 2026 · PMID 42161298 · DOI 10.1088/1748-605x/ae70e3
preclinical-animal
Europe PMC · 2026 · PMID 42356430 · DOI 10.3390/ph19060811
preclinical-animal
Europe PMC · 2026 · PMID 42710948 · DOI 10.1136/rapm-2025-107404
preclinical-animal
Europe PMC · 2026 · PMID 42189020 · DOI 10.1016/j.neurom.2026.04.006
human-interventional
Europe PMC · 2026 · PMID 42676398 · DOI 10.3389/fchem.2026.1913741
preclinical-animal
Europe PMC · 2026 · PMID 41628204
human-interventional
Europe PMC · 2026 · PMID 42361918 · DOI 10.1016/j.bcp.2026.118199
preclinical-animal
Europe PMC · 2025 · PMID 40084697 · DOI 10.1002/rcm.10026
preclinical-animal
Europe PMC · 2025 · PMID 39883049 · DOI 10.1089/jpm.2024.0130
human-observational
Europe PMC · 2025 · PMID 40864047 · DOI 10.3390/toxins17080371
preclinical-animal
Europe PMC · 2025 · PMID 40985013 · DOI 10.2147/jpr.s528946
preclinical-animal
Europe PMC · 2025 · PMID 40494817 · DOI 10.1021/acs.molpharmaceut.4c01030
preclinical-animal
Europe PMC · 2025 · PMID 40168566 · DOI 10.36076/ppj.2025.28.147
human-observational
Europe PMC · 2025 · PMID 41079656 · DOI 10.1039/d5sc05617a
preclinical-animal
Europe PMC · 2025 · PMID 41255849 · DOI 10.1097/pr9.0000000000001363
synthesis
Europe PMC · 2025 · PMID 38954510 · DOI 10.1080/14786419.2024.2373965
preclinical-animal
Europe PMC · 2025 · PMID 39230529 · DOI 10.1016/j.neurom.2024.07.007
human-observational
governance and regulatory context
No new outcome conclusion is inferred from discovery metadata. Named accountable approval is required for governed scientific conclusions.
2 FDA structured product label record(s) were identified for this compound name in openFDA. Label presence reflects an approved product exists under that name; it is not a claim about the specific formulation, dose, or use being discussed anywhere else on this page.
No machine-proposed evidence-strength grades exist yet for this compound; all screening records are unassigned pending further review.
Ziconotide evidence · ranking key
A tier describes the evidentiary role and design strength of a source. It is not a popularity score, proof that every conclusion is correct, or a substitute for claim-level review.
Large, well-conducted randomized trials; prespecified major outcomes; rigorous systematic reviews or meta-analyses; and major regulatory assessments.
Smaller randomized trials, strong prospective cohorts, prespecified secondary analyses, and high-quality comparative-effectiveness studies.
Retrospective cohorts, claims-database studies, pharmacovigilance analyses, mechanistic human research, and well-documented case series.
Case reports, conference abstracts, preclinical research, hypothesis-generating analyses, and expert commentary.
APA
World Peptide Foundation. (n.d.). Ziconotide — Peptide Scientific Intelligence. World Peptide Foundation. (Updated September 23, 2026.) https://www.worldpeptidefoundation.org/directory/ziconotide
AMA / Vancouver
World Peptide Foundation. Ziconotide — Peptide Scientific Intelligence. World Peptide Foundation website. Updated September 23, 2026. https://www.worldpeptidefoundation.org/directory/ziconotide
Featured tiered studies
0
Cornerstone publications with study-level interpretation, limitations, and tier disclosure.
Research domains
6
Clinical and scientific questions synthesized independently across the evidence atlas.
Governed reviewed evidence
142
Database records promoted through the governed publication workflow—not the corpus total.
Corpus generated 2026-09-18. Counts remain separately labeled to prevent automated screening from being represented as completed human review.
Human experience · separate evidence stream
Eligible observations remain below the privacy and reliability threshold. WPF will not convert a handful of reports into a percentage, trend, or clinical claim.
Observation is valuable human context. It is not evidence of causation, efficacy, or safety.
Public display gate
n ≥ 20 eligible observations
Exact progress remains private before the threshold.
Intelligence snapshot
A compact view of what is represented, what remains unresolved, and how completely the record can be traced.
Ranked research corpus
399
Categorized screening records; proposed rankings remain pending human appraisal.
Featured tiered studies
0
Cornerstone studies with published study-level interpretation and tier disclosure.
Research domains
6
Independent evidence dossiers covering the major research questions.
Governed reviewed evidence
142
Reviewed database records promoted through the governed publication workflow.
Contradictions
0
Conflicting evidence relationships that remain visible.
Research gaps
1
Questions the current record identifies as unresolved.
Connected media
0
Media records explicitly linked to this scientific record.
What we know
The project separates represented evidence from qualification, contradiction, uncertainty, and what the evidence does not establish.
Reconciled domain conclusions
Ziconotide no longer relies on the legacy “no public claim” state. Each research domain publishes a bounded conclusion, confidence level, evidence synthesis, limitations, geographic applicability, regulatory interpretation, and research gaps.
Inspect the reconciled evidence atlasContent-verified record concerning Ziconotide: "A randomized, double-blind, placebo-controlled study of intrathecal ziconotide in adults with severe chronic pain." Abstract excerpt: Safety and efficacy data from a study of slow intrathecal (IT) ziconotide titration for the management of severe chronic pain are presented. Patients randomized to ziconotide (n = 112) or placebo (n = 108) started IT infusion at 0.1 microg/hour (2.4 microg/day), increasing gradually (0.05-0.1 microg/hour increments) over 3 weeks. The ziconotide mean dose at termination was 0.29 microg/hour (6.96 m
Scientific context
Existing reviewed chemistry is preserved as scientific context. Chemistry and mechanism information do not establish clinical efficacy or safety.
Chemical identity describes the recorded molecular information. It does not establish biological activity, clinical efficacy, safety, or therapeutic suitability.
Explore further
Move from this peptide record into the project's broader evidence, research, comparison, and methodology systems.
Research
Chronology, unresolved research questions, opportunities, and researcher activity remain descriptive rather than evaluative.
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European Union — EMA
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United States — FDA
The represented chronology reflects records currently included in the governed dataset and does not claim to represent the entire scientific literature.
No institutional claim record is currently represented for this peptide.
Evidence is missing or not represented as studied; this is not a conclusion that the intervention does not work.
Connections
Connections appear only when they are represented by the project’s underlying records.
institution
institution
institution
Traceability
The experience makes incomplete links visible instead of presenting a false impression of perfect provenance.
Source publication state
A governed source may be verified and approved for publication while its claim-to-evidence link is still incomplete.
Reviewer provenance state
“Human scientist reviewed: no” means that specific source-path attribution is not recorded. It does not silently negate the separate publication-review state.
Domain conclusion → Evidence
Connected
Evidence → Source
Connected
Source → Original record
Connected
Traceability documents how the project connects statements to records. It does not establish that a source is scientifically valid or that a claim is clinically true.
Reconciled for 6 domain conclusions and 0 featured studies.
Detailed study-to-domain mappings and original-source paths appear in the Ziconotide evidence-governance section.
Inspect the ranked source recordsObservational archive
Observational archive data is intentionally separated from published scientific evidence.
Observational boundary
Insufficient eligible observations are available for display under the current filters.
Insufficient eligible observations are currently represented to display aggregated findings for this peptide.
Regulatory context
Regulatory status is jurisdiction-specific and time-dependent. It is presented as context, not as a recommendation for use or a substitute for scientific evidence evaluation.
European Union — EMA
Regulator: EMA
As of: 9/23/2026 · Temporal status not established
United States — FDA
Regulator: FDA
As of: 9/23/2026 · Temporal status not established
Research + media
Only media explicitly linked through the project’s relationship system appears here.
No scientifically connected media is currently represented for this peptide.
Sources + provenance
Generated: 9/24/2026, 3:24:47 AM
Tier classifies source design and evidentiary role. Confidence reflects risk of bias, sample size, comparator quality, outcome relevance, follow-up, missing data, directness, replication, reporting quality, and whether conclusions stay within the measured results.
Funding and conflicts are disclosed and considered, but sponsorship never automatically changes a tier. Corrections, retractions, and expressions of concern override the original rating.
Content-verified record concerning Ziconotide: "Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS: a randomized controlled trial." Abstract excerpt: Ziconotide (formerly SNX-111) selectively blocks N-type voltage-sensitive calcium channels and may be effective in patients with pain that is refractory to opioid therapy or those with intolerable opioid-related adverse effects. To assess the safety and efficacy of intrathecal ziconotide in patients with pain that is refractory to conventional treatment. Double-blind, placebo-controlled, randomize
Content-verified record concerning Ziconotide: "Ziconotide Trialing by Intrathecal Bolus Injections: An Open-Label Non-Randomized Clinical Trial in Postoperative/Posttraumatic Neuropathic Pain Patients Refractory to Conventional Treatment." Abstract excerpt: The aim of this open-label, non-randomized, clinical trial was to evaluate the feasibility of trialing ziconotide by intrathecal bolus injections. Twenty-three patients, who had peripheral neuropathic pain refractory to pharmacological treatment and were under consideration for Spinal Cord Stimulation, received up to three ziconotide bolus injections according to a comprehensive algorithm. After a
Content-verified record concerning Ziconotide: "Intrathecal ziconotide in the treatment of chronic nonmalignant pain: a randomized, double-blind, placebo-controlled clinical trial." Abstract excerpt: Objective.  The safety and efficacy of intrathecal (IT) ziconotide was studied in a randomized, double-blind, placebo-controlled trial. Materials and Methods.  Patients (169 ziconotide, 86 placebo) with severe chronic nonmalignant pain unresponsive to conventional therapy and a visual analog scale of pain intensity (VASPI score) ≥ 50 mm were treated over a 6-day
Content-verified record concerning Ziconotide: "Phase II, open-label, multicenter study of combined intrathecal morphine and ziconotide: addition of ziconotide in patients receiving intrathecal morphine for severe chronic pain." Abstract excerpt: To assess the safety and efficacy of adding intrathecal ziconotide to intrathecal morphine in patients being treated with a stable intrathecal morphine dose. Phase II, multicenter, open-label study with a 5-week titration phase and an extension phase. Outpatient clinics. Patients with suboptimal pain relief receiving stable intrathecal morphine doses (2-20 mg/day). Intrathecal morphine dosing rema
Content-verified record concerning Ziconotide: "[Experience in treatment of patients with neuropathic facial pain using ziconotide]." Abstract excerpt: We report on the intrathecal use of ziconotide in three patients with idiopathic facial pain after surgery of the mouth, jaw or face and one patient with neuropathic pain after damage of the lingual nerve. The therapy was successful in three patients but one patient with idiopathic facial pain had pain relief only during the test phase of ziconotide with an external pump and not after implanting t
Content-verified record concerning Ziconotide: "Ziconotide for the treatment of severe spasticity after spinal cord injury." Abstract excerpt: Spasticity is a major clinical manifestation of spinal cord injury and upper motor neuron syndrome.
Content-verified record concerning Ziconotide: "Italian registry on long-term intrathecal ziconotide treatment." Abstract excerpt: Ziconotide is commonly used for intrathecal (IT) therapy of chronic pain, and has been recently indicated as a first-line IT drug. It is also extremely useful for patients intolerant or refractory to the common IT drugs (such as morphine). The literature, excluding registration studies, mostly includes small samples, and gives only fragmentary evidence on the long-term risks and benefits of zicono
Content-verified record concerning Ziconotide: "Treatment challenges and complications with ziconotide monotherapy in established pump patients." Abstract excerpt: The U.S. Food and Drug Administration (FDA) recently approved Ziconotide intrathecal infusion for the management of severe chronic pain in patients for whom intrathecal therapy is warranted, and who are intolerant of, or refractory to, other methods of treatment, including intrathecal morphine. Ziconotide is approved as a monotherapy, but there are challenges associated with the decision to wean i
Content-verified record concerning Ziconotide: "Trigeminal neuralgia relief with intrathecal ziconotide." Abstract excerpt: We report a case of a 59-year-old female with severe TN who experienced satisfactory symptom relief from a single-shot trial of intrathecal ziconotide. Performed a 1 μg single-shot trial of Prialt. Report of satisfaction, no side effects, and complete face and back relief briefly but most notably relief from the TN. Ziconotide should be considered for treatment of TN, although further invest
Content-verified record concerning Ziconotide: "[Neuropsychiatric side effects of intrathecal ziconotide]." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Pain therapeutics from cone snail venoms: From Ziconotide to novel non-opioid pathways." Abstract excerpt: There have been numerous attempts to develop non-opioid drugs for severe pain, but the vast majority of these efforts have failed. A notable exception is Ziconotide (Prialt®), approved by the FDA in 2004. In this review, we summarize the present status of Ziconotide as a therapeutic drug and introduce a wider framework: the potential of venom peptides from cone snails as a resource providing
Content-verified record concerning Ziconotide: "Dilution of Ziconotide for Intrathecal Trial: The Effect of Dilution on the Incidence of Side Effects and Pain Relief: A Single-center Retrospective Case-control Study." Abstract excerpt: The optimal dosing and delivery strategies for intrathecal ziconotide are debated.  Previous research suggests that high volume, low concentration dosing techniques may decrease side effects and enhance analgesic effect. Previous studies that have investigated the effects of diluting ziconotide have examined continuous infusions of the medication through an intrathecal pump. This study invest
Content-verified record concerning Ziconotide: "Acute cardiovascular toxicity of low-dose intrathecal ziconotide." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for the treatment of chronic pain: a collection of clinical experiences and literature review." Abstract excerpt: Despite the wide use of ziconotide in the USA for treating refractory cancer- and noncancer-related pain, this agent is little used in Europe, even if licensed by the European Medicines Agency (EMA). The reason could be attributed to the high, fixed starting dose required for ziconotide, as stated in the EMA Summary of Product Characteristics (SmPC). This dosage recommendation is based on the resu
Content-verified record concerning Ziconotide: "Ziconotide intrathecal delivery as treatment for secondary therapeutic failure of motor cortex stimulation after 6 years." Abstract excerpt: Motor cortex stimulation is a well-known treatment modality for refractory neuropathic pain. Nevertheless, some cases of therapeutic failure have been described but alternative therapies for these cases are rarely reported. The patient presented with neuropathic pain in his right arm due to a cervical syrinx which was surgically treated by a shunt in 2003 with no clinical improvement. As alte
Content-verified record concerning Ziconotide: "[What became of Prialt®? : Observational study on the use of ziconotide in the treatment of chronic pain]." Abstract excerpt: Prialt® was approved by the European Medicine Agency in February 2005. Besides morphine, it is the only analgesic approved for long-term intrathecal infusion in the treatment of chronic pain. As it does not bind to opioid receptors, its use in the treatment of chronic pain seemed to be safer and to lead to less adverse events compared with morphine. However, it is an orphan drug and studies o
Content-verified record concerning Ziconotide: "Intrathecal Ziconotide and Morphine for Pain Relief: A Case Series of Eight Patients with Refractory Cancer Pain, Including Five Cases of Neuropathic Pain." Abstract excerpt: Studies have shown that, at low doses and with careful titration, combination therapy with intrathecal ziconotide and morphine results in rapid control of opioid-refractory cancer pain. However, there is a lack of published data regarding the efficacy and safety of intrathecal ziconotide specifically for the treatment of neuropathic cancer pain. Case reports of ziconotide intrathecal infusion in e
Content-verified record concerning Ziconotide: "Intrathecal ziconotide and baclofen provide pain relief in seven patients with neuropathic pain and spasticity: case reports." Abstract excerpt: Seven cases of combination of intrathecal (IT) ziconotide and baclofen therapy in patients with refractory neuropathic pain and spasticity were reviewed. Five of the seven adult patients were receiving IT baclofen treatment when ziconotide was initiated. All five patients had experienced at least one previous failed IT treatment regimen. Pain intensity scores improved by a mean of 50.3% with the u
Content-verified record concerning Ziconotide: "Adverse effects associated with the intrathecal administration of ziconotide." Abstract excerpt: The omega-conopeptide, ziconotide, is an N-type calcium-channel blocker that has been shown to produce antinociception in animals using formalin and hot-plate tests. Initial reports of intrathecal administration of ziconotide in cancer and AIDS patients whose pain was unrelieved with opioids demonstrated analgesic efficacy. Although adverse effects were reported, these appeared to be easily manage
Content-verified record concerning Ziconotide: "Intractable delirium associated with ziconotide successfully treated with electroconvulsive therapy." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Acute rhabdomyolysis in a patient with long-term exposure to intrathecal ziconotide: a case report." Abstract excerpt: Ziconotide is an intrathecally administered nonopioid analgesic for the treatment of severe chronic pain. Previous reports have noted rhabdomyolysis in patients receiving ziconotide during the initial single-shot trial or due to concurrent medical problems. We present a case of an acute rhabdomyolysis following an intrathecal bolus injection of ziconotide on a patient who had long-term exposure to
Content-verified record concerning Ziconotide: "Psychiatric predisposition to autonomic and abnormal perception side-effects of ziconotide: a case series study." Abstract excerpt:   Ziconotide is a reversible blocker of the N-type neuronal voltage-sensitive calcium channels with analgesic effects. The main adverse effects of ziconotide are ataxia, dizziness, gait disorder, confusion, hallucinations, and gastrointestinal symptoms.   Eighteen chronic pain patients with intrathecal ziconotide treatment were investigated using the Mini International Neuropsychiatr
Content-verified record concerning Ziconotide: "Case report: successful treatment of a patient with trigeminal neuropathy using ziconotide." Abstract excerpt: A 50-year-old female patient with chronic neuropathic pain in the distribution of the second branch of the trigeminal nerve was unsuccessfully treated over several years. Intrathecal therapy with ziconotide was administered at an initial dose of 0.33 microg/d, which was gradually increased by 0.7 microg/d. Subjective pain on the numeric rating scale was reduced from 9/10 to 3-4/10 at a dose of 6.3
Content-verified record concerning Ziconotide: "Use of Low Dose Ziconotide as First-Line Intrathecal Monotherapy." Abstract excerpt: Ziconotide use in intrathecal drug therapy (IDT) has been limited by dosing related side effects. We examine our experience with ziconotide as a first line IDT monotherapy in patients with chronic pain and present our low and slow dosing algorithm aimed at reducing these patient experienced side effects while adequately managing pain. We retrospectively reviewed demographics, dosing, and outcomes
Content-verified record concerning Ziconotide: "Perioperative Management of a Patient With an Intrathecal Drug Delivery Device Infusing Ziconotide: A Case Report." Abstract excerpt: Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug del
Content-verified record concerning Ziconotide: "Short-Term Outcomes of a High-Volume, Low-Concentration Bolus Starting Dose Technique With Ziconotide: A Case Series." Abstract excerpt: There have been numerous recommendations for a starting dose of intrathecal ziconotide. The therapy remains underutilized partially due to reports of inefficacy and/or intolerance. This study describes short-term outcomes of a high-volume, low-concentration bolus (HVLC-B) ziconotide starting dose technique for patients with chronic spine pain. Intrathecal pumps are available with a Patient Therapy
Content-verified record concerning Ziconotide: "Does pain relief influence recovery of consciousness? A case report of a patient treated with ziconotide." Abstract excerpt: For people with cervical spinal cord injury (SCI), access to computers can be difficult, thus several devices have been developed to facilitate their Disorders of consciousness (DOC) are difficult to classify. The degree of consciousness varies from coma to vegetative state or unresponsive wakefulness syndrome (UWS) and minimally conscious state. Correct diagnosis has important ethical and legal i
Content-verified record concerning Ziconotide: "Aseptic arachnoiditis in a patient treated with intrathecal morphine infusion: symptom resolution on switch to ziconotide." Abstract excerpt: Since 1980, about 95,000 intrathecal (IT) drug delivery pumps have been implanted for the administration of a variety of opioid and non-opioid agents for neuropathic and nociceptive pain patients. IT granuloma in chronic opioid infusion is becoming less rare as an adverse effect of IT therapy and has been associated with many analgesic infusion agents. After thymectomy, upper left lobectomy, and p
Content-verified record concerning Ziconotide: "An effective treatment of severe complex regional pain syndrome type 1 in a child using high doses of intrathecal ziconotide." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Successful reduction of neuropathic pain associated with spinal cord injury via of a combination of intrathecal hydromorphone and ziconotide: a case report." Abstract excerpt: Case report. To report a novel management strategy for neuropathic pain management after spinal cord injury. Outpatient spinal cord injury (SCI) clinic. The patient demonstrated two neuropathic pain syndromes, namely at- and below-level pain. These syndromes were recalcitrant to conservative measures and a decision was made to proceed with intrathecal therapies. The patient's at-level pain was res
Content-verified record concerning Ziconotide: "Low-Dose Intrathecal Ziconotide for Spasticity From Primary Lateral Sclerosis: A Case Report." Abstract excerpt: Spasticity can be very debilitating and painful. We present a case of severe spasticity from primary lateral sclerosis refractory to intrathecal baclofen in doses up to 1100 μg/d. Baclofen was weaned down and switched to intrathecal ziconotide at 0.6 μg/d. The dose was then titrated up to 3 μg/d with excellent control of spasticity. This case suggests that low-dose intrathecal zi
Content-verified record concerning Ziconotide: "Dyskinesia caused by ziconotide-baclofen combination in an adolescent affected by cerebral palsy." Abstract excerpt: To report on the first case of ziconotide-induced dyskinesia. Ziconotide, a synthetic peptide analogue of the ω-conotoxin MVIIA that blocks selectively N-type voltage-sensitive calcium channels, has been used in intrathecal administration for 30 years. Ziconotide is a drug of choice for chronic pain because of its efficacy and flexibility because it can substitute or complement other intrath
Content-verified record concerning Ziconotide: "Ziconotide for the Management of Cancer Pain: A Budget Impact Analysis." Abstract excerpt: Recent recommendations on starting dose, smaller dose increments, and longer intervals between dose increase have the potential to increase the safety of ziconotide administration in addition to improving its value for money. Ziconotide is not routinely commissioned in England, with one of the concerns being whether it represents the best use of resources. The aim of this project is to conduct a b
Content-verified record concerning Ziconotide: "Ziconotide-induced psychosis: A case report and literature review." Abstract excerpt: Ziconotide is an intrathecally administered medication indicated for the treatment of severe chronic pain in patients who are intolerant of or refractory to other treatment options. A black box warning is included in the packaging and states ziconotide is contraindicated in patients with a preexisting history of psychosis. Patients taking ziconotide should be monitored for evidence of cognitive im
Content-verified record concerning Ziconotide: "Ziconotide-induced psychosis: a case report." Abstract excerpt: Ziconotide is used intrathecally in the management of severe chronic pain that contains a warning against neuropsychiatric adverse events. The definition of psychiatric events is broad and management strategies are vague. This case report describes a 49-year-old female who was admitted to the acute psychiatric unit to address auditory hallucinations and paranoid ideation persisting for 3 weeks. Ap
Content-verified record concerning Ziconotide: "Intrathecal Administration of Ziconotide as a Potential Treatment for Chronic Migraines." Abstract excerpt: Migraine is one of the most prevalent and debilitating illnesses globally. There are multitudes of treatment options available for migraines. One of the emerging treatment options for migraine, refractory to conventional treatment modalities, is the intrathecal Ziconotide. Ziconotide (Prialt, Jazz Pharmaceuticals, Dublin, Ireland) enforces selective block of N-type calcium channels, which control
Content-verified record concerning Ziconotide: "Intrathecal pain management with ziconotide: Time for consensus?" Abstract excerpt: This article summarizes recommendations made by six pain specialists who discussed the rationale for ziconotide intrathecal analgesia (ITA) and the requirement for evidence-based guidance on its use, from a European perspective. Riemser Pharma GmbH (Greifswald, Germany), which holds the European marketing authorization for ziconotide, hosted the meeting. The group agreed that ITA is under-used in
Content-verified record concerning Ziconotide: "Continuous Intrathecal Infusion of Ziconotide for Treatment of Chronic Malignant and Nonmalignant Pain Over 12 Months: A Prospective, Open-label Study." Abstract excerpt: Objectives.  This study aims to assess the safety and efficacy of long-term intrathecal (IT) ziconotide infusion. Materials and Methods.  In this prospective study, 155 patients with severe chronic pain (48 with malignant pain, 107 with nonmalignant pain) who had been responsive to short-term IT ziconotide in a double-blind, placebo-controlled study received long-term, open-label IT
Content-verified record concerning Ziconotide: "Effectiveness and Safety of Intrathecal Ziconotide: Final Results of the Patient Registry of Intrathecal Ziconotide Management (PRIZM)." Abstract excerpt: The Patient Registry of Intrathecal Ziconotide Management evaluated the long-term effectiveness and safety of intrathecal ziconotide. The study was a prospective, multicenter observational study of intrathecal ziconotide in US clinical practice. Patients were adults with severe chronic pain that warranted intrathecal therapy. Ziconotide was initiated as the single agent in the pump; however, other
Content-verified record concerning Ziconotide: "Effectiveness and Safety of Intrathecal Ziconotide: Interim Analysis of the Patient Registry of Intrathecal Ziconotide Management (PRIZM)." Abstract excerpt: The Patient Registry of Intrathecal Ziconotide Management (PRIZM) evaluated long-term effectiveness, safety, and tolerability of intrathecal ziconotide treatment in clinical practice. Patient Registry of Intrathecal Ziconotide Management was an open-label, long-term, multicenter, observational study of adult patients with severe chronic pain. This interim analysis (data through July 10, 2015) of z
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for neuropathic pain: a review." Abstract excerpt: Neuropathic pain is a considerable burden that affects activities of daily living. The management of neuropathic pain can be challenging because of multiple etiologies and complex manifestations. Ziconotide is a nonopioid intrathecal (IT) analgesic option for patients with neuropathic pain refractory to conventional treatments. The objective of this article is to review the published literature on
Content-verified record concerning Ziconotide: "Intrathecal Ziconotide Infusion Therapy for Oncologic Refractory Neuropathic Pain: Case Report With High-Dose Intraventricular Ziconotide After 15 Years of Treatment." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Ziconotide-Induced Oro-lingual Dyskinesia: 3 Cases." Abstract excerpt: Ziconotide (ZCN), a nonopioid analgesic, is first-line intrathecal therapy for patients with severe chronic pain refractory to other management options. We describe three cases of ZCN-induced movement disorders. Case one is a 64-year-old woman who presented with oro-lingual (OL) dyskinesia with dysesthesias and bilateral upper extremity kinetic tremor. Case two is a 43-year-old man with a 20-month
Content-verified record concerning Ziconotide: "Ziconotide for treatment of severe chronic pain." Abstract excerpt: Pharmacological management of severe chronic pain is difficult to achieve with currently available analgesic drugs, and remains a large unmet therapeutic need. The synthetic peptide ziconotide has been approved by the US Food and Drug Administration and the European Medicines Agency for intrathecal treatment of patients with severe chronic pain that is refractory to other treatment modalities. Zic
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for chronic pain." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Ziconotide--a novel neuron-specific calcium channel blocker for the intrathecal treatment of severe chronic pain--a short review." Abstract excerpt: Worldwide a large number of patients suffer from severe chronic pain even after treatment with opioids following the 3-step analgesic ladder developed by the WHO. Intraspinal agents, including morphine, have been tried as a fourth step. However, approximately 20% of cases remain refractory. Ziconotide, an intrathecal analgesic with orphan drug status, is a novel alternative for the management of c
Content-verified record concerning Ziconotide: "The Relationship Between the Mechanisms of Action and Safety Profiles of Intrathecal Morphine and Ziconotide: A Review of the Literature." Abstract excerpt: To better characterize safety profiles associated with the intrathecal (IT) administration of morphine and ziconotide and discuss how they relate to mechanisms of action. Published data were evaluated to identify potential relationships between safety profiles of IT morphine and IT ziconotide and their mechanisms of action. Potentially severe and clinically relevant adverse events (AEs) associated
Content-verified record concerning Ziconotide: "The neuroprotective effects of intrathecal administration of the selective N-type calcium channel blocker ziconotide in a rat model of spinal ischemia." Abstract excerpt: Spinal cord ischemia and resulting paraplegia represent a major complication associated with surgical repair of the thoracoabdominal aorta. Although the mechanism of spinal neuronal degeneration during ischemia is unclear, it may involve excessive calcium influx via N-type voltage-sensitive calcium channels (VSCCs). The neuroprotective capacity of intrathecal (IT) administration of the selective N
Content-verified record concerning Ziconotide: "CNSB004 (Leconotide) causes antihyperalgesia without side effects when given intravenously: a comparison with ziconotide in a rat model of diabetic neuropathic pain." Abstract excerpt: Leconotide is an omega-conotoxin that blocks neuronal voltage sensitive calcium channels. This study compared the antihyperalgesic potencies of leconotide and ziconotide given intravenously alone and in combinations with a potassium channel modulator flupirtine, given intraperitoneally, in a rat model of diabetic neuropathic pain. Rats were given streptozotocin (150 mg/kg ip) to induce diabetic ne
Content-verified record concerning Ziconotide: "Ziconotide: an update and review." Abstract excerpt: Ziconotide is the only N-type calcium channel blocker approved by the US FDA for the treatment of chronic pain. The approved indication is for the management of severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments such as systemic analgesics, adjunctive therapies or intrathecal morphine. The purpose of this article wa
Content-verified record concerning Ziconotide: "Effects of intrathecal administration of ziconotide, a selective neuronal N-type calcium channel blocker, on mechanical allodynia and heat hyperalgesia in a rat model of postoperative pain." Abstract excerpt: Ziconotide (SNX-111), a selective blocker of neuronal N-type voltage-sensitive calcium channels, is antinociceptive when it is administered intrathecally. It is currently under clinical investigation for the treatment of malignant and non-malignant pain syndromes. The present study was undertaken to compare and contrast antinociceptive properties of ziconotide, morphine and clonidine in a rat mode
Content-verified record concerning Ziconotide: "Influence of pH and temperature on ziconotide stability in intrathecal analgesic admixtures in implantable pumps and syringes." Abstract excerpt: The aim of our study was to investigate the influence of pH and temperature on the stability of ziconotide in analgesic admixtures containing morphine and ropivacaine. All admixtures were combined using a wide range of concentrations, in implantable pumps and syringes, using temperatures from 4°C to 37°C. Quantification was made thanks to a specific chromatographic technique. pH has also
Content-verified record concerning Ziconotide: "Interactions of intrathecally administered ziconotide, a selective blocker of neuronal N-type voltage-sensitive calcium channels, with morphine on nociception in rats." Abstract excerpt: Ziconotide is a selective, potent and reversible blocker of neuronal N-type voltage-sensitive calcium channels (VSCCs). Morphine is an agonist of mu-opioid receptors and inhibits N-type VSCC channels via a G-protein coupling mechanism. Both agents are antinociceptive when they are administered intrathecally (spinally). The present study investigated the acute and chronic (7-day) interactions of in
Content-verified record concerning Ziconotide: "The Pharmacology of Spinal Opioids and Ziconotide for the Treatment of Non-Cancer Pain." Abstract excerpt: Intrathecal drug delivery has undergone a revitalization following a better understanding of this delivery route and its pharmacokinetics. Driven by patient safety and outcomes, clinicians are motivated to rethink the traditional spinal infusion pump patient selection criteria and indications. We review the current understanding of the pharmacology of commonly employed intrathecal agents and the c
Content-verified record concerning Ziconotide: "Antidepressant-like and memory-enhancing effects of the N-type calcium channel blocker ziconotide in rats." Abstract excerpt: The lack of oral or injectable formulations of ziconotide (ω-conotoxin peptide), a novel analgesic agent, limits research on potential neurobehavioral protective properties of this substance, including antidepressant-like effects. Here we expose rats to a stress paradigm that induces depression and memory impairment to assess the effects of ziconotide treatment. Ziconotide was administered i
Content-verified record concerning Ziconotide: "Can Ziconotide Be Used to Replace Opioids? Exploratory Clinical Experience in 5 Patients Treated in the Pain Unit." Abstract excerpt: Ziconotide and morphine are intrathecal (IT) drugs approved by the FDA and EMA for the treatment of chronic pain. The aim of this study was to determine whether opioid rescue can be achieved by gradually increasing doses of ziconotide, and to establish a practical protocol for its implementation. Five patients unresponsive to IT morphine due to lack of efficacy or adverse events such as endocrine
Content-verified record concerning Ziconotide: "Dilution and compounding of ziconotide for intrathecal administration." Abstract excerpt: Intrathecal therapy is an established treatment option for patients with severe chronic pain who do not receive adequate relief from less invasive methods. Ziconotide is the only nonopioid analgesic approved by the U.S. Food and Drug Administration for intrathecal administration. Ziconotide is approved for monotherapy only, but combination intrathecal therapy is considered an acceptable treatment
Content-verified record concerning Ziconotide: "[New medications; ziconotide]." Abstract excerpt: Ziconotide is a synthetic analogue of a peptide found in the poison of the marine snail Conus magus. Ziconotide blocks N-type calcium channels, which play an important role in the transmission of pain signals in the dorsal ganglia of the spinal cord. The drug is indicated for 'severe chronic pain' and is administered intrathecally.
Content-verified record concerning Ziconotide: "Statistical evaluation of the chemical stability of ziconotide solutions during simulated intrathecal administration." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Spinal morphine but not ziconotide or gabapentin analgesia is affected by alternative splicing of voltage-gated calcium channel CaV2.2 pre-mRNA." Abstract excerpt: Presynaptic voltage-gated calcium Ca(V)2.2 channels play a privileged role in spinal level sensitization following peripheral nerve injury. Direct and indirect inhibitors of Ca(V)2.2 channel activity in spinal dorsal horn are analgesic in chronic pain states. Ca(V)2.2 channels represent a family of splice isoforms that are expressed in different combinations according to cell-type. A pair of mutua
Content-verified record concerning Ziconotide: "Chemical Stability of Morphine, Ropivacaine, and Ziconotide in Combination for Intrathecal Analgesia." Abstract excerpt: Pain is the most feared symptom amongst individuals living with cancer. In 15% to 20% of patients, conventional analgesic therapy either fails to relieve pain or induces adverse effects. Intrathecal drug delivery systems may present an effective alternative for pain management. The Cancerology Center Paul Papin protocol includes an admixture of morphine, ropivacaine, and ziconotide in intrathecal
Content-verified record concerning Ziconotide: "Using ziconotide for intrathecal infusions." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Stability Study of Admixtures Combining Ziconotide With Morphine or Sufentanil in Polypropylene Syringes." Abstract excerpt: The association of morphine ziconotide or sufentanil ziconotide was used to manage cancer pain. Moving these patients is sometimes difficult. In order to transport these syringes for pump refilling, it could be interesting to demonstrate the stability of the mixture and so to be able to ensure the best transport conditions of syringes. A stability indicating UPLC-DAD method was developed and valid
Content-verified record concerning Ziconotide: "In vitro stability of low-concentration ziconotide alone or in admixtures in intrathecal pumps." Abstract excerpt: Ziconotide is often administered in combination with other analgesics via an intrathecal pump. Studies have established that ziconotide is stable when delivered alone in high concentrations. No stability data are available, however, for ziconotide given in low concentrations and/or with other analgesics as usually occurs in clinical oncology practice. The objective of this study was to assess the
Content-verified record concerning Ziconotide: "Effects of an N-type calcium channel antagonist (SNX 111; Ziconotide) on calcium-45 accumulation following fluid-percussion injury." Abstract excerpt: Accumulation of calcium following experimental traumatic brain injury (TBI) has been demonstrated to be a prominent pathophysiological component that can compromise mitochondrial functioning and threaten cell survival. The omega-conopeptide SNX-111, also known as Ziconotide, is a potent antagonist of the voltage-gated N-type calcium channel and has demonstrated significant neuroprotective effects
Content-verified record concerning Ziconotide: "Physicochemical Stability Study of the Morphine-Bupivacaine-Ziconotide Association." Abstract excerpt: The aim of this study was to investigate the physicochemical stability of morphine-bupivacaine-ziconotide mixtures used in intrathecal analgesia in polypropylene syringes and intrathecal pumps. The stability study method was conceived according to International Council for Harmonisation guidelines. For propylene syringes, six different mixtures of morphine-bupivacaine and ziconotide were assessed
Content-verified record concerning Ziconotide: "Ziconotide: neuronal calcium channel blocker for treating severe chronic pain." Abstract excerpt: Ziconotide (PRIALT) is a neuroactive peptide in the final stages of clinical development as a novel non-opioid treatment for severe chronic pain. It is the synthetic equivalent of omega-MVIIA, a component of the venom of the marine snail, Conus magus. The mechanism of action underlying ziconotide's therapeutic profile derives from its potent and selective blockade of neuronal N-type voltage-sensit
Content-verified record concerning Ziconotide: "Physicochemical Stability Study of the Morphine-Ropivacaine-Ziconotide Association in Implantable Pumps for Intrathecal Administration." Abstract excerpt: This study aimed to investigate the physicochemical stability of morphine-ropivacaine-ziconotide mixtures used in intrathecal analgesia. Eight mixtures were studied to assess their stability profiles according to the initial drug concentrations used. The solutions obtained were put in implantable pumps and stored at 37 °C over a period of 60 days. Assays were performed using ultra high-pressu
Content-verified record concerning Ziconotide: "Chemical stability of ziconotide-clonidine hydrochloride admixtures with and without morphine sulfate during simulated intrathecal administration." Abstract excerpt: Objective.  To determine the stability of ziconotide-clonidine hydrochloride admixtures with and without morphine sulfate during simulated intrathecal infusion under laboratory conditions at 37°. Materials and Methods.  Admixtures of ziconotide (25 µg/mL) and clonidine hydrochloride (2 mg/mL) with and without morphine sulfate (35 mg/mL) were stored in Medtron
Content-verified record concerning Ziconotide: "Long-term intrathecal ziconotide therapy: a case study and discussion." Abstract excerpt: This case study describes the therapeutic result of intrathecal administration of ziconotide, a new synthetic neurotoxin derived from the venom of the Philippine marine snail, Conus Magus, to a 48-year-old male with chronic, and previously untreatable, neuropathic pain of an undeterminable etiology. The patient suffered tactile allodynia and reported his baseline pain intensity to be 80 mm on the
Content-verified record concerning Ziconotide: "Intrathecal Ziconotide Long-Term Management in Chronic Postamputation Pain." Abstract excerpt: The clinical case of a young patient with intractable residual limb pain is presented. Following the initial administration of opioids and subsequent overuse, the patient was switched to intrathecal (IT) ziconotide infusion with complete opioid withdrawal. After 15 years of treatment with ziconotide infusion, the patient achieved sustained analgesic control and excellent functional recovery. IT zi
Content-verified record concerning Ziconotide: "Ziconotide: a clinical update and pharmacologic review." Abstract excerpt: Ziconotide is an N-type calcium channel antagonist to treat chronic pain that is delivered intrathecally. It is the only intrathecal, FDA-approved, non-opioid analgesic and is recommended as first-line therapy. Despite these advantages, a small therapeutic window limits ziconotide's clinical utility, with adverse event (AE) challenges that include, but are not limited to, dizziness, nausea, and so
Content-verified record concerning Ziconotide: "Delivery of ziconotide to cerebrospinal fluid via intranasal pathway for the treatment of chronic pain." Abstract excerpt: The purpose of the current study was to investigate the plausibility of delivery of ziconotide to the cerebrospinal fluid (CSF) via intranasal administration. Ziconotide was administered either in the form of solution or Kolliphor P 407 gels (KP 407) intranasally in Sprague-Dawley rats. The effect of incorporation of chitosan in the formulation was also investigated. Time course of drug in the CSF
Content-verified record concerning Ziconotide: "Neurobehavioral protection by the neuronal calcium channel blocker ziconotide in a model of traumatic diffuse brain injury in rats." Abstract excerpt: Abnormal accumulation of intracellular calcium following traumatic brain injury (TBI) is thought to contribute to a cascade of cellular events that lead to neuropathological conditions. Therefore, the possibility that specific calcium channel antagonists might exert neuroprotective effects in TBI has been of interest. The focus of this study was to examine whether Ziconotide produces such neuropro
Content-verified record concerning Ziconotide: "Microneedle-mediated delivery of Ziconotide-loaded liposomes fused with exosomes for analgesia." Abstract excerpt: Ziconotide (ZIC) is an N-type calcium channel antagonist for treating severe chronic pain that is intolerable, or responds poorly to the administration of other drugs, such as intrathecal morphine and systemic analgesics. As it can only work in the brain and cerebrospinal fluid, intrathecal injection is the only administration route for ZIC. In this study, borneol (BOR)-modified liposomes (LIPs) w
Content-verified record concerning Ziconotide: "Intrathecal combination of ziconotide and morphine for refractory cancer pain: a rapidly acting and effective choice." Abstract excerpt: Ziconotide is a nonopioid intrathecal analgesic drug used to manage moderate to severe chronic pain. The aim of this work is to assess the safety and efficacy of intrathecal (IT) combination of ziconotide and morphine in malignant pain refractory to high doses of oral opioids. Patients with malignant pain refractory to high oral opioids doses with a mean visual analogue scale of pain intensity (VA
Content-verified record concerning Ziconotide: "Dual Effect of Ziconotide in Primary Erythromelalgia." Abstract excerpt: Erythromelalgia (EM) is a rare disabling clinical syndrome more commonly known to affect the lower extremities. There is no single effective treatment for this disease that often requires a multidisciplinary approach. Herein, we report the case of a 31-year-old woman affected by primary erythromelalgia who was successfully treated with intrathecal Ziconotide. We also observed an unexpected result
Content-verified record concerning Ziconotide: "Pharmacokinetic analysis of ziconotide (SNX-111), an intrathecal N-type calcium channel blocking analgesic, delivered by bolus and infusion in the dog." Abstract excerpt:   Ziconotide is a peptide that blocks N-type calcium channels and is antihyperalgesic after intrathecal (IT) delivery. We here characterize the spinal kinetics of IT bolus and infused ziconotide in dog.   Male beagle dogs (N= 5) were prepared with chronic IT lumbar injection and cerebrospinal fluid (LCSF) sampling catheters connected to vest-mounted pumps. Each dog received the follo
Content-verified record concerning Ziconotide: "Intracerebroventricular administration of N-type calcium channel blocker ziconotide displays anticonvulsant, anxiolytic, and sedative effects in rats: A preclinical and pilot study." Abstract excerpt: Ziconotide (ω-conotoxin MVIIA peptide) is a novel analgesic agent acting on voltage-gated calcium channels and is administered intrathecally for neuropathic pain. While antiepileptic activities of other types of calcium channel blockers (T- or L-type) are well established, there is no information regarding the effect of ziconotide as an N-type calcium channel antagonist in pentylenetetrazol-
Content-verified record concerning Ziconotide: "Intracerebroventricular Pain Treatment with Analgesic Mixtures including Ziconotide for Intractable Pain." Abstract excerpt: Intracerebroventricular (ICV) administration of opioids for control of intractable cancer pain has been used since 1982. We present here our experience of intracerebroventricular administration of pain treatments including ziconotide associated with morphine and ropivacaine for patients resistant to a conventional approach, with nociceptive, neuropathic, or mixed pain. These clinical cases were co
Content-verified record concerning Ziconotide: "Tailored delivery of analgesic ziconotide across a blood brain barrier model using viral nanocontainers." Abstract excerpt: The blood brain barrier (BBB) is often an insurmountable obstacle for a large number of candidate drugs, including peptides, antibiotics, and chemotherapeutic agents. Devising an adroit delivery method to cross the BBB is essential to unlocking widespread application of peptide therapeutics. Presented here is an engineered nanocontainer for delivering peptidic drugs across the BBB encapsulating th
Content-verified record concerning Ziconotide: "An evaluation of intrathecal ziconotide for the treatment of chronic pain." Abstract excerpt: Ziconotide, the synthetic form of cone snail peptide pi-conotoxin MVIIA, is a neurone-specific N-type calcium channel blocker with an analgesic and neuroprotective effect. Intrathecal ziconotide has been recommended for approval by the FDA for the management of chronic pain. Spinally administered ziconotide produces analgesia by blocking neurotransmitter release from primary nociceptive afferents
Content-verified record concerning Ziconotide: "[Recommendations for the management of chronic pain by intrathecal ziconotide]." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Study of Physicochemical Stability of Ziconotide in Medication Cassette Reservoir." Abstract excerpt: To determine the physicochemical stability of ziconotide solutions for intrathecal administration in the Medication Cassette Reservoir (MCR). A stability indicating UPLC-DAD method was developed and validated according to the ICH guidelines. Two mixtures of ziconotide (0.40 μg/mL and 0.60 μg/mL) stored in MCR stored at 25 ± 2°C were evaluated for 14 days and compared to the i
Content-verified record concerning Ziconotide: "A Chemoenzymatic Approach To Produce a Cyclic Analogue of the Analgesic Drug MVIIA (Ziconotide)." Abstract excerpt: Ziconotide (ω-conotoxin MVIIA) is an approved analgesic for the treatment of chronic pain. However, the need for intrathecal administration and adverse effects have limited its widespread application. Backbone cyclization is one way to improve the pharmaceutical properties of conopeptides, but so far chemical synthesis alone has been unable to produce correctly folded and backbone cyclic ana
Content-verified record concerning Ziconotide: "A comprehensive review on ziconotide." Abstract excerpt: Managing severe chronic pain is a challenging task, given the limited effectiveness of available pharmacological and non-pharmacological treatments. This issue continues to be a significant public health concern, requiring a substantial therapeutic response. Ziconotide, a synthetic peptide initially isolated from Conus magus in 1982 and approved by the US Food and Drug Administration and the Europ
Content-verified record concerning Ziconotide: "Ziconotide and psychosis: from a case report to a scoping review." Abstract excerpt: Ziconotide is a non-opioid analgesic that acts on N-type voltage-gated calcium channels. Despite its proven effectiveness in pain treatment, it can induce neuropsychiatric symptoms. The aim of this article is to present a case of psychosis secondary to ziconotide and to explore the variety of neuropsychiatric symptoms it produces, exploring the relationship between these symptoms and the mechanism
Content-verified record concerning Ziconotide: "Improvement in mitochondrial dysfunction as a new surrogate efficiency measure for preclinical trials: dose-response and time-window profiles for administration of the calcium channel blocker Ziconotide in experimental brain injury." Abstract excerpt: Determining the efficacy of a drug used in experimental traumatic brain injury (TBI) requires the use of one or more outcome measures such as decreased mortality or fewer neurological and neuropsychological deficits. Unfortunately, outcomes in these test batteries have a fairly large variability, requiring relatively large sample sizes, and administration of the tests themselves is also very time
Research overview for defined ziconotide; direct trial and official labeling should govern clinical claims.
Content-verified record concerning Ziconotide: "Ziconotide: a new option for refractory pain." Abstract excerpt: Ziconotide has been introduced as a new nonopioid treatment for chronic pain. Structurally, it is a peptide, the synthetic analog of the omega-conotoxin, derived from the marine snail, Conus magus. N-type voltage-sensitive calcium channels play a role in the transmission of nociceptive stimuli and also are involved in the release of neurotransmitters important in pain transmission. Ziconotide's th
Content-verified record concerning Ziconotide: "Ziconotide for spinal cord injury-related pain." Abstract excerpt: Central neuropathic pain related to spinal cord injury is notoriously difficult to treat. So far most pharmacological and surgical options have shown but poor results. Recently ziconotide has been approved for use both neuropathic and non-neuropathic pain. In this cohort study, we assessed responder rate and long-term efficacy of intrathecal ziconotide in patients with pain related to spinal cord
Content-verified record concerning Ziconotide: "USAN Council. List No.421. New names. Ziconotide." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Ziconotide Combination Intrathecal Therapy for Noncancer Pain Is Limited Secondary to Delayed Adverse Effects: A Case Series With a 24-Month Follow-Up." Abstract excerpt: The efficacy and safety of ziconotide as a single agent has been evaluated in few short-term clinical trials and open-label studies. Ziconotide use is challenging given its adverse effect (AE) profile. The objective of this study is to describe the long-term efficacy and AEs of ziconotide used as an adjunct to other intrathecal (IT) agents in chronic noncancer pain patients. A case series of chron
Content-verified record concerning Ziconotide: "Ziconotide adverse events in patients with cancer pain: a multicenter observational study of a slow titration, multidrug protocol." Abstract excerpt: Ziconotide is a new analgesic agent administered intrathecally. It is challenging to use and can induce several and sometimes serious adverse events. A low initial dosage followed by slow titration may reduce serious adverse events. To determine whether a low starting dosage of ziconotide, followed by slow titration, decreases the incidence of major adverse events associated with ziconotide when u
Content-verified record concerning Ziconotide: "Ziconotide combination intrathecal therapy: rationale and evidence." Abstract excerpt: Ziconotide is a nonopioid intrathecal analgesic used to manage moderate to severe chronic pain. Although ziconotide is approved in the United States for intrathecal monotherapy only, it is often used in combination with other intrathecal drugs in clinical practice. The need exists for a critical assessment of the currently available published literature on ziconotide combination therapy. This revi
Content-verified record concerning Ziconotide: "Ziconotide: a review of its pharmacology and use in the treatment of pain." Abstract excerpt: Ziconotide is a powerful analgesic drug that has a unique mechanism of action involving potent and selective block of N-type calcium channels, which control neurotransmission at many synapses. The analgesic efficacy of ziconotide likely results from its ability to interrupt pain signaling at the level of the spinal cord. Ziconotide is a peptidic drug and has been approved for the treatment of seve
Content-verified record concerning Ziconotide: "Ziconotide: a new nonopioid intrathecal analgesic for the treatment of chronic pain." Abstract excerpt: Ziconotide is a new nonopioid intrathecal agent recently approved for the treatment of chronic pain. Ziconotide is indicated for the management of severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatment, such as systemic analgesics, adjunctive therapies or intrathecal morphine. Ziconotide blocks the N-type calcium channel
Content-verified record concerning Ziconotide: "Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain." Abstract excerpt: Ziconotide intrathecal infusion was recently approved by the United States Food and Drug Administration for the treatment of intractable severe chronic pain. Patients with neuropathic pain make up a significant population among those who experience chronic pain for which there are less than optimal pharmacotherapeutic options. Published clinical trials provide a global view of ziconotide efficacy
Content-verified record concerning Ziconotide: "Ziconotide: can we use it in palliative care?" Abstract excerpt: Ziconotide (PRIALT) is a new nonopioid treatment for chronic pain. It is a peptide that is the synthetic analog of the omega-conotoxin, derived from the marine snail, Conus magus. The therapeutic benefit of ziconotide derives from its potent and selective blockade of neuronal N-type voltage-sensitive calcium channels. Interference with these channels inhibits input from pain-sensing primary nocice
Content-verified record concerning Ziconotide: "Ziconotide, an intrathecally administered N-type calcium channel antagonist for the treatment of chronic pain." Abstract excerpt: Ziconotide is a novel peptide that blocks the entry of calcium into neuronal N-type voltage-sensitive calcium channels, preventing the conduction of nerve signals. N-type calcium channels are present in the superficial laminae of the dorsal horn of the spinal cord. In various animal models of pain, intrathecal administration of ziconotide blocked nerve transmission and nociception. The United Stat
Content-verified record concerning Ziconotide: "Ziconotide (Elan Pharmaceuticals)." Abstract excerpt: Elan Pharmaceuticals (formerly Neurex) is developing ziconotide, a neuron-specific N-type calcium channel blocker, for the potential treatment of severe pain and ischemia. A US NDA for the use of the compound in intractable pain is under review [351606,357600] and phase III trials for ischemia are ongoing [261455,292579]. Elan received an approvable letter from the FDA for pain in June 2000, and b
Content-verified record concerning Ziconotide: "Intrathecal Ziconotide: Dosing and Administration Strategies in Patients With Refractory Chronic Pain." Abstract excerpt: Ziconotide is a non-opioid analgesic for intrathecal (IT) administration. The aim of this review is to provide a comprehensive and clinically relevant summary of the literature on dosing and administration with IT ziconotide in the management of refractory chronic pain, and to describe novel dosing strategies intended to improve clinical outcomes. A Medline search was conducted for "ziconotide," s
Content-verified record concerning Ziconotide: "Ziconotide, a new N-type calcium channel blocker, administered intrathecally for acute postoperative pain." Abstract excerpt: Voltage-sensitive calcium channel conductance is essential for the nervous system to signal a painful event. However, intrathecal administration of L-type calcium channel blockers does not provide analgesia. The present investigation was designed to assess the safety and analgesic efficacy of ziconotide, a new N-type calcium channel blocker, when administered intrathecally to patients with acute p
Content-verified record concerning Ziconotide: "Ziconotide Monotherapy: A Systematic Review of Randomised Controlled Trials." Abstract excerpt: Chronic neuropathic pain is difficult to treat and is often refractory to most modalities of treatment. Ziconotide is a novel, potent, non-opioid, calcium channel blocking agent which has been shown in clinical trials to be effective in treating chronic neuropathic pain. EMBASE, MEDLINE, CINAHL Plus and Web of Science electronic databases were searched for English language studies. Reference secti
Content-verified record concerning Ziconotide: "Intrathecal ziconotide: a review of its use in patients with chronic pain refractory to other systemic or intrathecal analgesics." Abstract excerpt: Ziconotide (Prialt(®)) is a synthetic conopeptide analgesic that acts by selectively antagonizing N-type voltage-gated calcium channels. Intrathecal ziconotide is the only non-opioid intrathecal analgesic that is FDA-approved for use in patients with treatment-refractory, chronic pain. The efficacy of intrathecal ziconotide was demonstrated in randomized, double-blind, placebo-controlled tria
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for complex regional pain syndrome: seven case reports." Abstract excerpt: Ziconotide is a nonopioid analgesic currently indicated as monotherapy, but frequently used in combination with opioids, for the management of severe chronic pain in patients for whom intrathecal (IT) therapy is warranted and who are intolerant of, or whose pain is, refractory to other treatments. There is a paucity of information regarding ziconotide use in patients with complex regional pain syn
Content-verified record concerning Ziconotide: "Intrathecal ziconotide and opioid combination therapy for noncancer pain: an observational study." Abstract excerpt: Intrathecal ziconotide is used to manage severe chronic pain. Although ziconotide is approved by the US Food and Drug Administration for monotherapy, it is sometimes used in combination with other intrathecal drugs for the management of intractable pain conditions in clinical practice. Evaluate the safety and tolerability of ziconotide combination therapy. A retrospective, observational study. A s
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for severe chronic pain: safety and tolerability results of an open-label, long-term trial." Abstract excerpt: Ziconotide is a non-opioid drug indicated for management of severe chronic pain in patients for whom intrathecal (IT) therapy is warranted and who are intolerant of or refractory to other treatments. Six-hundred and forty-four patients with severe chronic pain participated in this open-label, multicenter study. Ziconotide titration was followed by long-term infusion. Efficacy assessments included
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for refractory pain." Abstract excerpt: For cancer and AIDS patients, 10-30% of pain is refractory to strong opioids, requiring intraspinal administration for pain management. Ziconotide is a selective N-type calcium channel blocker, which inhibits neurotransmitter release, and following intrathecal administration will affect primary nociceptive afferents. In 108 patients with previously unmanaged refractory pain despite the use of syst
Content-verified record concerning Ziconotide: "Administering ziconotide and monitoring patients treated with ziconotide: expert opinions." Abstract excerpt: Some patients with chronic pain who are intolerant of or refractory to treatment with systemic analgesics may benefit from intrathecal therapy. Ziconotide is the first nonopioid analgesic approved by the United States Food and Drug Administration for intrathecal administration. Several randomized, double-blind, placebo-controlled clinical trials have demonstrated the efficacy and safety of ziconot
Content-verified record concerning Ziconotide: "Real-Life Data on Ziconotide-Based Intrathecal Therapy in Patients With Cancer Pain: Interim Analysis of the Observational Practice in Clinics Registry." Abstract excerpt: This study aimed to provide real-world data on the utilization of ziconotide-containing intrathecal (IT) treatment. This ongoing European multicenter, prospective observational study included patients experiencing severe refractory chronic pain, eligible for IT analgesia using ziconotide. Patients are treated and observed according to the site's usual practice. The study includes an interim analys
Content-verified record concerning Ziconotide: "Bioavailability of Ziconotide in brain: influx from blood, stability, and diffusion." Abstract excerpt: Ziconotide is a selective peptide antagonist of the N-type calcium channel currently in clinical trials for analgesia. Ziconotide reached a maximal brain concentration of between 0.003 and 0.006% of the injected material per gram of tissue at 3-20 min after i.v. injection, and this decayed to below 0.001%/g after 2 h. The structurally distinct conopeptide SNX-185 (synthetic TVIA) was considerably
Content-verified record concerning Ziconotide: "Effect of First-Line Ziconotide Intrathecal Drug Therapy for Neuropathic Pain on Disability, Emotional Well-Being, and Pain Catastrophizing." Abstract excerpt: Previous studies have shown decreased pain scores with ziconotide as a first-line agent for intrathecal drug therapy (IDT). Subset analysis suggests that patients with neuropathic pain have greater improvement. We prospectively examine the role of first-line ziconotide IDT on the tridimensional pain experience in ziconotide IDT-naive patients with neuropathic pain. We included patients who underwe
Content-verified record concerning Ziconotide: "Long-term intrathecal ziconotide for chronic pain: an open-label study." Abstract excerpt: This open-label multicenter study evaluated the long-term safety and efficacy of intrathecal ziconotide and included 78 patients with chronic pain who had completed one of two previous ziconotide clinical trials. Each patient's initial ziconotide dose was based on his or her dose from the study of origin and was adjusted as necessary on the basis of adverse events and analgesic effect. The median
Content-verified record concerning Ziconotide: "Cost-effectiveness of ziconotide in intrathecal pain management for severe chronic pain patients in the UK." Abstract excerpt: To examine the cost-effectiveness of using intrathecal ziconotide in the treatment of severe chronic pain compared to best supportive care for patients with intractable chronic pain in the United Kingdom. Using a simulation model, the analysis evaluated the cost and health economic consequences of using ziconotide as a treatment for severe chronic pain. The modelled population and clinical data we
Content-verified record concerning Ziconotide: "Nonclinical safety of ziconotide: an intrathecal analgesic of a new pharmaceutical class." Abstract excerpt: Ziconotide, a potent, selective, reversible blocker of neuronal N-type voltage-sensitive calcium channels, is approved in the United States for the management of severe chronic pain in patients for whom intrathecal therapy is warranted, and who are intolerant or refractory to other treatment, such as systemic analgesics, adjunctive therapies, or intrathecal morphine. In the European Union, ziconot
Content-verified record concerning Ziconotide: "Intrathecal therapy with ziconotide: clinical experience and considerations on its use." Abstract excerpt: Ziconotide is a synthetic peptide equivalent of an w-conotoxin, obtained from the marine snail Conus magus, which acts by blocking N-type calcium channels in the spinal cord, reducing the perception of pain. It is a newly marketed drug, exclusively for intrathecal use, indicated for severe chronic pain. Ziconotide came to the physicians' table with both doubts and promises; to determine its safety
Content-verified record concerning Ziconotide: "Bolus intrathecal injection of ziconotide (Prialt®) to evaluate the option of continuous administration via an implanted intrathecal drug delivery (ITDD) system: a pilot study." Abstract excerpt: This study evaluated efficacy and safety of bolus doses of ziconotide (Prialt®, Eisai Limited, Hertfordshire, UK) to assess the option of continuous administration of this drug via an implanted intrathecal drug delivery system. Twenty adults with severe chronic pain who were under consideration for intrathecal (IT) therapy were enrolled in this open label, nonrandomized, pilot study. Informed
Content-verified record concerning Ziconotide: "Safety and efficacy of intrathecal ziconotide in the management of severe chronic pain." Abstract excerpt: Ziconotide is a conopeptide intrathecal (IT) analgesic which is approved by the US Food and Drug Administration (FDA) for the management of severe chronic pain. It is a synthetic equivalent of a naturally occurring conopeptide found in the venom of the fish-eating marine cone snail and provides analgesia via binding to N-type voltage-sensitive calcium channels in the spinal cord. As ziconotide is
Content-verified record concerning Ziconotide: "A Benefit/Risk Assessment of Intrathecal Ziconotide in Chronic Pain: A Narrative Review." Abstract excerpt: Ziconotide is an intrathecal drug administered for the treatment of chronic pain. The current literature lacks an exhaustive benefit/risk assessment on this drug. We herein focus on Ziconotide's pharmacology and clinical applications. Literature research was conducted to identify studies on Ziconotide administration for the treatment of chronic pain, published between January 1990 and March 2023 a
Content-verified record concerning Ziconotide: "Ziconotide for Management of Cancer Pain Refractory to Pharmacotherapy: An Update." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Ziconotide (Prialt) for chronic pain." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Ziconotide. CI 1009, SNX 111." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "[Ziconotide: an innovative alternative for intense chronic neuropathic pain]." Abstract excerpt: Intense chronic pain is a very important health problem, as it has a high prevalence (5-10%), a multifactorial aetiology and its management is very often a very complex affair. Treatment of severe cases sometimes requires interventional approaches, such as continuous intrathecal infusion of opioids. We report the case of a 38-year-old female with intense neuropathic pain in the lower back and the
Content-verified record concerning Ziconotide: "Can ziconotide as a N-type voltage-sensitive calcium channel blocker open a new mode for treatment of autism? A hypothesis." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Elan: ziconotide review focused on off-label uses." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Ziconotide: A rapid detoxification protocol for the conversion from intrathecal morphine--the Raffaeli Detoxification Model." Abstract excerpt: To assess the efficacy and the safety of our rapid detoxificationprotocol in preventing signs and symptoms of withdrawal and pain severity. Prospective, open-label case series study. Public primary care at the Pain and Palliative Care Unit of the Infermi Hospital of Rimini, Italy. The authors studied 10 consecutive patients suffering from chronic noncancer pain who were refractory to intrathecal (
Content-verified record concerning Ziconotide: "New drugs: tigecycline, ziconotide, and clofarabine." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Increased risk of suicide under intrathecal ziconotide treatment? - a warning." Abstract excerpt: Despite some other known psychiatric adverse effects, ziconotide is recommended for intrathecal pain treatment with a good efficacy and safety. Although some hints in previous studies are apparent, a higher suicidality has not been accepted as a treatment risk of ziconotide treatment by the investigators in the former randomized controlled trials so far. We present two cases supporting the suspici
Content-verified record concerning Ziconotide: "Considerations and methodology for trialing ziconotide." Abstract excerpt: Before long-term intrathecal analgesic therapy is initiated, patients often undergo a spinal analgesia trial. Ziconotide is a nonopioid intrathecal analgesic used to manage severe chronic pain, and a variety of methods have been used to trial ziconotide. The purpose of this review is to compare and discuss the different methods of ziconotide trialing. Various databases (i.e., PubMed, Excerpta Medi
Content-verified record concerning Ziconotide: "Pharmacokinetics and pharmacodynamics of intrathecal ziconotide in chronic pain patients." Abstract excerpt: The pharmacokinetics and pharmacodynamics of ziconotide were assessed over a 48-hour period following intrathecal (i.t.) administration (1, 5, 7.5, or 10 micrograms) to 22 patients with chronic, nonmalignant pain. Plasma and cerebrospinal fluid (CSF) samples were obtained over a 24-hour period. Analgesic efficacy was monitored using Visual Analog Scale of Pain Intensity (VASPI) and Category Pain R
Content-verified record concerning Ziconotide: "SPIDOL study protocol for the assessment of intrathecal ziconotide antalgic efficacy for severe refractory neuropathic pain due to spinal cord lesions." Abstract excerpt: Central neuropathic pain resulting from spinal cord injury is notoriously debilitating and difficult to treat with few currently available treatments. A novel molecule with intrathecal administration: Ziconotide has been approved for treatment of refractory neuropathic pain in general. It acts as a presynaptic calcium channel blocker. A pilot study has shown its potential in SCI neuropathic pain p
Content-verified record concerning Ziconotide: "Intrathecal Therapy for Chronic Pain: A Review of Morphine and Ziconotide as Firstline Options." Abstract excerpt: To evaluate the evidence for morphine and ziconotide as firstline intrathecal (IT) analgesia agents for patients with chronic pain. Medline was searched (through July 2017) for "ziconotide" or "morphine" AND "intrathecal" AND "chronic pain," with results limited to studies in human populations. The literature supports the use of morphine (based primarily on noncontrolled, prospective, and retrospe
Content-verified record concerning Ziconotide: "Intrathecal therapy: what has changed with the introduction of ziconotide." Abstract excerpt: Administering drugs into the intrathecal space is becoming more popular in the treatment of patients with intractable pain or intolerable side effects of systemic analgesic treatments. Although morphine and ziconotide are the only intrathecal analgesics currently approved by regulatory authorities in the U.S. (Food and Drug Administration) and Europe (national-level approval by individual countrie
Content-verified record concerning Ziconotide: "Long-Term Follow-Up (>11 Years) on Successful Pregnancies With Ziconotide Monotherapy for Arachnoiditis-Related Chronic Pain." (identity confirmed; no abstract text available to excerpt.)
Content-verified record concerning Ziconotide: "Open-label, multicenter study of combined intrathecal morphine and ziconotide: addition of morphine in patients receiving ziconotide for severe chronic pain." Abstract excerpt: To assess the safety and efficacy of adding intrathecal morphine to intrathecal ziconotide in patients treated with stable ziconotide doses. Multicenter, open-label study with a 4-week morphine titration phase during which ziconotide was held constant and an extension phase during which dosing of either drug could vary. Outpatient clinics. Patients with suboptimal pain relief receiving stable zico
Content-verified record concerning Ziconotide: "Do the potential benefits outweigh the risks? An update on the use of ziconotide in clinical practice." Abstract excerpt: Ziconotide is a selective and potent blocker of N-type voltage-gated calcium channels. It was approved by the Food and Drug Administration in 2004 and by the European Medicines Agency in 2005 for the treatment of severe chronic pain in patients needing intrathecal analgesia (ITA). The aim of this paper is to provide a practitioner-oriented, educational, narrative, up-to-date review on the use of z
Content-verified record concerning Ziconotide: "Structure of human Ca<sub>v</sub>2.2 channel blocked by the painkiller ziconotide." Abstract excerpt: The neuronal-type (N-type) voltage-gated calcium (Ca v ) channels, which are designated Ca v 2.2, have an important role in the release of neurotransmitters 1-3 . Ziconotide is a Ca v 2.2-specific peptide pore blocker that has been clinically used for treating intractable pain 4-6 . Here we present cryo-electron microscopy structures of human Ca v 2.2 (comprising the core α1 and the ancillar
Content-verified record concerning Ziconotide: "Intrathecal Pharmacology Update: Novel Dosing Strategy for Intrathecal Monotherapy Ziconotide on Efficacy and Sustainability." Abstract excerpt: Intrathecal drug delivery is a well-defined strategy to treat malignant and nonmalignant pain. Ziconotide is a well-studied intrathecal medicine option that has many attractive qualities, as it is non-granulomagenic, overdose or underdose is not associated with cardiopulmonary compromise or death, and is a non-opoid analgesic. However, it has had slow adoption into pain care algorithms because it
Content-verified record concerning Ziconotide: "Rationale for Prospective Assays of Intrathecal Mixtures Including Morphine, Ropivacaine and Ziconotide: Prevention of Adverse Events and Feasibility in Clinical Practice." Abstract excerpt: Use of intrathecal admixtures is widespread, but compounding these is sometimes challenging and may result in errors and complications causing super-potency or sub potency adverse events in patients or malfunctions in the pump itself. The purpose of this study is to evaluate the accuracy of compounding of intrathecal admixtures through a prospective, systematic quantitative analysis of each compon
Content-verified record concerning Ziconotide: "Intrathecal ziconotide for refractory chronic pain." Abstract excerpt: To describe the pharmacology, efficacy, and safety of ziconotide for treatment of severe chronic pain in patients who are candidates for intrathecal therapy. A PubMed/MEDLINE search (1966-June 2006) was conducted using the terms ziconotide, Prialt, and SNX-111. Manufacturer-provided data, the Food and Drug Administration medical review of ziconotide, and abstracts presented at American Pain Societ