Ziconotide Injection

Ziconotide injection is a prescription medication used for the treatment of chronic pain.

• Ziconotide is available under the following different brand names: Prialt.

Common side effects of Ziconotide include:

• dizziness
• spinning sensation
• drowsiness
• nausea
• headache
• weakness
• joint pain
• sleep problems
• unusual dreams
• stomach pain
• diarrhea
• constipation
• loss of appetite
• urinating less than usual
• loss of balance or coordination

Serious side effects of Ziconotide include:

• anxiety
• being forgetful
• change in walking and balance
• changes in patterns and rhythms of speech
• clumsiness or unsteadiness
• decrease in the frequency of urination
• decrease in urine volume
• delusions

Rare side effects of Ziconotide include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors.
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Intrathecal injection

• 25 mcg/mL
• 100 mcg/Ml

Chronic Pain

Adult dosage

• 2.4 mcg/day intrathecal (IT), (0.1 mcg/hour)
• Titrate up by 2.4 mcg/day at intervals 2-3 times per week or less if necessary: no more than 19.2 mcg/day (0.8 mcg/hour) by Day 21

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Ziconotide has severe interactions with no other drugs.
• Ziconotide has serious interactions with the following drugs:
  • calcium/magnesium/potassium/sodium oxybates
  • metoclopramide intranasal
  • olopatadine intranasal
  • ropeginterferon alfa 2b
  • sodium oxybate
• Ziconotide has moderate interactions with at least 181 other drugs.
• Ziconotide has minor interactions with at least 28 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• hypersensitivity
• history of psychosis
• IV administration
  • IT administration to patients with uncontrolled bleeding, infection at the injection site, and spinal obstruction that impairs CSF circulation

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Ziconotide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Ziconotide?”

Cautions

• IT administration only
• Possibility of severe psychiatric & neurological complications
• Risk of severe or worsening depression w/ suicide risk in susceptible pts.
• Monitor for cognitive impairment, hallucinations & mood swings.
• Can be interrupted or discontinued abruptly without withdrawal effects.
• Possibility of meningitis & other infections.
• Levels of serum creatinine kinase may increase.
• Pregnancy, lactation.

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Excretion into breast milk unknown; discontinue the drug or do not nurse.