archived version — not current
This is a permanent, read-only archive of this profile's public content as it existed on 2026-09-23. It does not reflect the current, live profile. View the current profile.
Ziconotide
Snapshot captured 2026-09-23 — Published content materially edited
Overview
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.
Evidence quality
WPF’s atlas includes clinical discussion of intrathecal ziconotide in persistent pain, alongside animal pharmacology, conotoxin discovery, and analytical methods. These sources have different evidentiary weight; an animal antinociception result does not establish patient benefit.
Safety concerns
This Directory entry has no published source-linked citations or jurisdiction-specific regulatory records. Patient selection, administration setting, neuropsychiatric and other adverse outcomes, and formal indications require primary and official source review.
Citations as of this version
- Intrathecal Ziconotide Long-Term Management in Chronic Postamputation Pain. (2026)
- Real-Life Data on Ziconotide-Based Intrathecal Therapy in Patients With Cancer Pain: Interim Analysis of the Observational Practice in Clinics Registry. (2026)
- 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. (2025)
- Can Ziconotide Be Used to Replace Opioids? Exploratory Clinical Experience in 5 Patients Treated in the Pain Unit. (2025)
- A comprehensive review on ziconotide. (2024)
- Intrathecal Ziconotide Infusion Therapy for Oncologic Refractory Neuropathic Pain: Case Report With High-Dose Intraventricular Ziconotide After 15 Years of Treatment. (2024)
- Intrathecal ziconotide for the treatment of chronic pain: a collection of clinical experiences and literature review. (2024)
- A Benefit/Risk Assessment of Intrathecal Ziconotide in Chronic Pain: A Narrative Review. (2024)
- SPIDOL study protocol for the assessment of intrathecal ziconotide antalgic efficacy for severe refractory neuropathic pain due to spinal cord lesions. (2024)
- Physicochemical Stability Study of the Morphine-Bupivacaine-Ziconotide Association. (2024)
- Ziconotide and psychosis: from a case report to a scoping review. (2024)
- Physicochemical Stability Study of the Morphine-Ropivacaine-Ziconotide Association in Implantable Pumps for Intrathecal Administration. (2023)
- Microneedle-mediated delivery of Ziconotide-loaded liposomes fused with exosomes for analgesia. (2023)
- A Chemoenzymatic Approach To Produce a Cyclic Analogue of the Analgesic Drug MVIIA (Ziconotide). (2023)
- Long-Term Follow-Up (>11 Years) on Successful Pregnancies With Ziconotide Monotherapy for Arachnoiditis-Related Chronic Pain. (2023)
- Ziconotide for the Management of Cancer Pain: A Budget Impact Analysis. (2023)
- Intrathecal Administration of Ziconotide as a Potential Treatment for Chronic Migraines. (2022)
- Stability Study of Admixtures Combining Ziconotide With Morphine or Sufentanil in Polypropylene Syringes. (2021)
- Short-Term Outcomes of a High-Volume, Low-Concentration Bolus Starting Dose Technique With Ziconotide: A Case Series. (2021)
- Structure of human Ca<sub>v</sub>2.2 channel blocked by the painkiller ziconotide. (2021)
- [What became of Prialt®? : Observational study on the use of ziconotide in the treatment of chronic pain]. (2021)
- Effect of First-Line Ziconotide Intrathecal Drug Therapy for Neuropathic Pain on Disability, Emotional Well-Being, and Pain Catastrophizing. (2021)
- Intrathecal pain management with ziconotide: Time for consensus? (2021)
- Antidepressant-like and memory-enhancing effects of the N-type calcium channel blocker ziconotide in rats. (2020)
- Ziconotide for Management of Cancer Pain Refractory to Pharmacotherapy: An Update. (2020)
- Effectiveness and Safety of Intrathecal Ziconotide: Final Results of the Patient Registry of Intrathecal Ziconotide Management (PRIZM). (2020)
- Ziconotide-Induced Oro-lingual Dyskinesia: 3 Cases. (2020)
- Study of Physicochemical Stability of Ziconotide in Medication Cassette Reservoir. (2020)
- Intracerebroventricular administration of N-type calcium channel blocker ziconotide displays anticonvulsant, anxiolytic, and sedative effects in rats: A preclinical and pilot study. (2020)
- Pain therapeutics from cone snail venoms: From Ziconotide to novel non-opioid pathways. (2019)
- Low-Dose Intrathecal Ziconotide for Spasticity From Primary Lateral Sclerosis: A Case Report. (2019)
- Ziconotide for spinal cord injury-related pain. (2019)
- Intrathecal Therapy for Chronic Pain: A Review of Morphine and Ziconotide as Firstline Options. (2019)
- Do the potential benefits outweigh the risks? An update on the use of ziconotide in clinical practice. (2018)
- Ziconotide-induced psychosis: A case report and literature review. (2018)
- Effectiveness and Safety of Intrathecal Ziconotide: Interim Analysis of the Patient Registry of Intrathecal Ziconotide Management (PRIZM). (2018)
- The Pharmacology of Spinal Opioids and Ziconotide for the Treatment of Non-Cancer Pain. (2017)
- Use of Low Dose Ziconotide as First-Line Intrathecal Monotherapy. (2017)
- Ziconotide Monotherapy: A Systematic Review of Randomised Controlled Trials. (2017)
- Perioperative Management of a Patient With an Intrathecal Drug Delivery Device Infusing Ziconotide: A Case Report. (2017)
- Chemical Stability of Morphine, Ropivacaine, and Ziconotide in Combination for Intrathecal Analgesia. (2017)
- Intrathecal Ziconotide: Dosing and Administration Strategies in Patients With Refractory Chronic Pain. (2016)
- Intracerebroventricular Pain Treatment with Analgesic Mixtures including Ziconotide for Intractable Pain. (2016)
- Does pain relief influence recovery of consciousness? A case report of a patient treated with ziconotide. (2016)
- Delivery of ziconotide to cerebrospinal fluid via intranasal pathway for the treatment of chronic pain. (2016)
- Ziconotide intrathecal delivery as treatment for secondary therapeutic failure of motor cortex stimulation after 6 years. (2016)
- Intrathecal Pharmacology Update: Novel Dosing Strategy for Intrathecal Monotherapy Ziconotide on Efficacy and Sustainability. (2015)
- Ziconotide-induced psychosis: a case report. (2015)
- Ziconotide Trialing by Intrathecal Bolus Injections: An Open-Label Non-Randomized Clinical Trial in Postoperative/Posttraumatic Neuropathic Pain Patients Refractory to Conventional Treatment. (2015)
- Ziconotide Combination Intrathecal Therapy for Noncancer Pain Is Limited Secondary to Delayed Adverse Effects: A Case Series With a 24-Month Follow-Up. (2015)
- Rationale for Prospective Assays of Intrathecal Mixtures Including Morphine, Ropivacaine and Ziconotide: Prevention of Adverse Events and Feasibility in Clinical Practice. (2015)
- Intrathecal Ziconotide and Morphine for Pain Relief: A Case Series of Eight Patients with Refractory Cancer Pain, Including Five Cases of Neuropathic Pain. (2015)
- Aseptic arachnoiditis in a patient treated with intrathecal morphine infusion: symptom resolution on switch to ziconotide. (2015)
- Dual Effect of Ziconotide in Primary Erythromelalgia. (2015)
- The Relationship Between the Mechanisms of Action and Safety Profiles of Intrathecal Morphine and Ziconotide: A Review of the Literature. (2015)
- Tailored delivery of analgesic ziconotide across a blood brain barrier model using viral nanocontainers. (2015)
- Acute rhabdomyolysis in a patient with long-term exposure to intrathecal ziconotide: a case report. (2015)
- Influence of pH and temperature on ziconotide stability in intrathecal analgesic admixtures in implantable pumps and syringes. (2015)
- Dyskinesia caused by ziconotide-baclofen combination in an adolescent affected by cerebral palsy. (2014)
- In vitro stability of low-concentration ziconotide alone or in admixtures in intrathecal pumps. (2014)
- Spinal morphine but not ziconotide or gabapentin analgesia is affected by alternative splicing of voltage-gated calcium channel CaV2.2 pre-mRNA. (2013)
- Acute cardiovascular toxicity of low-dose intrathecal ziconotide. (2013)
- Intrathecal ziconotide: a review of its use in patients with chronic pain refractory to other systemic or intrathecal analgesics. (2013)
- Ziconotide: a clinical update and pharmacologic review. (2013)
- Bolus intrathecal injection of ziconotide (Prialt®) to evaluate the option of continuous administration via an implanted intrathecal drug delivery (ITDD) system: a pilot study. (2013)
- Administering ziconotide and monitoring patients treated with ziconotide: expert opinions. (2013)
- Ziconotide adverse events in patients with cancer pain: a multicenter observational study of a slow titration, multidrug protocol. (2012)
- Intrathecal combination of ziconotide and morphine for refractory cancer pain: a rapidly acting and effective choice. (2012)
- Pharmacokinetic analysis of ziconotide (SNX-111), an intrathecal N-type calcium channel blocking analgesic, delivered by bolus and infusion in the dog. (2012)
- Psychiatric predisposition to autonomic and abnormal perception side-effects of ziconotide: a case series study. (2011)
- [Experience in treatment of patients with neuropathic facial pain using ziconotide]. (2011)
- Can ziconotide as a N-type voltage-sensitive calcium channel blocker open a new mode for treatment of autism? A hypothesis. (2011)
- Increased risk of suicide under intrathecal ziconotide treatment? - a warning. (2011)
- Trigeminal neuralgia relief with intrathecal ziconotide. (2011)
- Ziconotide: A rapid detoxification protocol for the conversion from intrathecal morphine--the Raffaeli Detoxification Model. (2011)
- Italian registry on long-term intrathecal ziconotide treatment. (2011)
- [Neuropsychiatric side effects of intrathecal ziconotide]. (2011)
- Ziconotide combination intrathecal therapy: rationale and evidence. (2010)
- [Recommendations for the management of chronic pain by intrathecal ziconotide]. (2010)
- Ziconotide for treatment of severe chronic pain. (2010)
- Considerations and methodology for trialing ziconotide. (2010)
- Case report: successful treatment of a patient with trigeminal neuropathy using ziconotide. (2010)
- CNSB004 (Leconotide) causes antihyperalgesia without side effects when given intravenously: a comparison with ziconotide in a rat model of diabetic neuropathic pain. (2010)
- Intrathecal therapy: what has changed with the introduction of ziconotide. (2009)
- Intrathecal ziconotide for neuropathic pain: a review. (2009)
- Intrathecal ziconotide for complex regional pain syndrome: seven case reports. (2009)
- Intrathecal ziconotide and opioid combination therapy for noncancer pain: an observational study. (2009)
- Cost-effectiveness of ziconotide in intrathecal pain management for severe chronic pain patients in the UK. (2009)
- Long-term intrathecal ziconotide for chronic pain: an open-label study. (2009)
- Safety and efficacy of intrathecal ziconotide in the management of severe chronic pain. (2009)
- Intrathecal ziconotide and baclofen provide pain relief in seven patients with neuropathic pain and spasticity: case reports. (2009)
- Dilution and compounding of ziconotide for intrathecal administration. (2008)
- Intrathecal ziconotide for severe chronic pain: safety and tolerability results of an open-label, long-term trial. (2008)
- Using ziconotide for intrathecal infusions. (2008)
- Intrathecal therapy with ziconotide: clinical experience and considerations on its use. (2008)
- Statistical evaluation of the chemical stability of ziconotide solutions during simulated intrathecal administration. (2008)
- Ziconotide: an update and review. (2008)
- Continuous Intrathecal Infusion of Ziconotide for Treatment of Chronic Malignant and Nonmalignant Pain Over 12 Months: A Prospective, Open-label Study. (2008)
- Open-label, multicenter study of combined intrathecal morphine and ziconotide: addition of morphine in patients receiving ziconotide for severe chronic pain. (2008)
- Phase II, open-label, multicenter study of combined intrathecal morphine and ziconotide: addition of ziconotide in patients receiving intrathecal morphine for severe chronic pain. (2008)
- Chemical stability of ziconotide-clonidine hydrochloride admixtures with and without morphine sulfate during simulated intrathecal administration. (2007)
- Nonclinical safety of ziconotide: an intrathecal analgesic of a new pharmaceutical class. (2007)
- [Ziconotide: an innovative alternative for intense chronic neuropathic pain]. (2007)
- Successful reduction of neuropathic pain associated with spinal cord injury via of a combination of intrathecal hydromorphone and ziconotide: a case report. (2007)
- Ziconotide: a review of its pharmacology and use in the treatment of pain. (2007)
- A randomized, double-blind, placebo-controlled study of intrathecal ziconotide in adults with severe chronic pain. (2006)
- Treatment challenges and complications with ziconotide monotherapy in established pump patients. (2006)
- An effective treatment of severe complex regional pain syndrome type 1 in a child using high doses of intrathecal ziconotide. (2006)
- [New medications; ziconotide]. (2006)
- Intrathecal ziconotide in the treatment of chronic nonmalignant pain: a randomized, double-blind, placebo-controlled clinical trial. (2006)
- Ziconotide--a novel neuron-specific calcium channel blocker for the intrathecal treatment of severe chronic pain--a short review. (2006)
- Ziconotide infusion for severe chronic pain: case series of patients with neuropathic pain. (2006)
- Ziconotide: a new nonopioid intrathecal analgesic for the treatment of chronic pain. (2006)
- Intrathecal ziconotide for refractory chronic pain. (2006)
- Ziconotide: a new option for refractory pain. (2006)
- Ziconotide. (2006)
- Ziconotide (Prialt) for chronic pain. (2005)
- Ziconotide, an intrathecally administered N-type calcium channel antagonist for the treatment of chronic pain. (2005)
- Ziconotide: can we use it in palliative care? (2005)
- Elan: ziconotide review focused on off-label uses. (2005)
- New drugs: tigecycline, ziconotide, and clofarabine. (2005)
- Ziconotide: neuronal calcium channel blocker for treating severe chronic pain. (2004)
- Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS: a randomized controlled trial. (2004)
- Intrathecal ziconotide for refractory pain. (2004)
- Intrathecal ziconotide for chronic pain. (2004)
- Pharmacokinetics and pharmacodynamics of intrathecal ziconotide in chronic pain patients. (2003)
- Intractable delirium associated with ziconotide successfully treated with electroconvulsive therapy. (2002)
- Ziconotide (Elan Pharmaceuticals). (2001)
- Long-term intrathecal ziconotide therapy: a case study and discussion. (2001)
- 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. (2000)
- Interactions of intrathecally administered ziconotide, a selective blocker of neuronal N-type voltage-sensitive calcium channels, with morphine on nociception in rats. (2000)
- Adverse effects associated with the intrathecal administration of ziconotide. (2000)
- An evaluation of intrathecal ziconotide for the treatment of chronic pain. (2000)
- 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. (2000)
- Ziconotide, a new N-type calcium channel blocker, administered intrathecally for acute postoperative pain. (2000)
- Neurobehavioral protection by the neuronal calcium channel blocker ziconotide in a model of traumatic diffuse brain injury in rats. (2000)
- Bioavailability of Ziconotide in brain: influx from blood, stability, and diffusion. (2000)
- Ziconotide for the treatment of severe spasticity after spinal cord injury. (2000)
- Ziconotide. CI 1009, SNX 111. (1999)
- Effects of an N-type calcium channel antagonist (SNX 111; Ziconotide) on calcium-45 accumulation following fluid-percussion injury. (1999)
- USAN Council. List No.421. New names. Ziconotide. (1999)
- The neuroprotective effects of intrathecal administration of the selective N-type calcium channel blocker ziconotide in a rat model of spinal ischemia. (1999)
Regulatory status as of this version
- European Union — EMA: approved — Ziconotide (Prialt) is indicated for the treatment of severe, chronic pain in patients who require intrathecal (IT) analgesia.
- United States — FDA: approved — PRIALT (ziconotide intrathecal infusion) is indicated for the management of severe chronic pain in patients for whom intrathecal (IT) therapy is warranted, and who are intolerant of or refractory to other treatment, such as systemic analgesics, adjunctive therapies, or IT morphine. Labeled pediatric use: safety and effectiveness in pediatric patients have not been established.
Content hash: be3db0fc667a65f249a09d258e9dff3ab63c6a3c248364427d51461134e1c61f