Overview of the Medication Ziconotide

What is ziconotide?

Ziconotide is in a new category of analgesics termed neuronal calcium channel blockers (NCCBs). It is a potent non-opioid pain relieving medication with no known risk of tolerance. Ziconotide is used for individuals who are candidates for intrathecal (IT) therapy and are intolerant of other systemic treatments or IT morphine.

How is ziconotide administered?

Ziconotide is the first new analgesic medication approved by the FDA for use in IT therapy since morphine was approved over 25 years ago. Intrathecal therapy involves the surgical implantation of a small device under the fat of the abdomen. The device, often referred to as a pain pump, has a medication reservoir that slowly releases medication to the fluid-filled space around the spinal cord via a catheter. The medication interrupts pain signals sent from the spine to the brain which eases the perception of pain.

A physician sets the dosage of ziconotide, and the pump regulates the flow rate of the medication. The reservoir is generally refilled once a month by a health care provider.

What are the possible side effects of ziconotide?

Side effects may include headache, joint pain, drowsiness, weakness, dizziness, spinning sensations, balance issues, sleep problems, unusual dreams, stomach pain, diarrhea, constipation, lack of appetite, loss of coordination, anemia, leg cramps and infrequent urination.

A physician should be consulted immediately if these side effects are experienced:

Problems with memory, speech, walking or thinking; feeling lightheaded; vision problems; new or worsening muscle pain, cramps, soreness or weakness; dark urine; unusual bleeding or signs of infection around the infusion entry or catheter exit sites; paranoia, hostility, disorientation, and confusion; odd sensations in the mouth; fever; neck stiffness; seizure; extreme drowsiness; and confusion, hallucinations, or decreased consciousness.

The following side effects are very serious and require emergency medical intervention as they are consistent with anaphylaxis:

Hives; breathing difficulties; swelling of the face, lips, tongue or throat.

Ziconotide should not be used if an individual has uncontrolled bleeding, a blood clotting condition or a history of psychiatric illness or psychosis. Individuals should avoid alcohol while taking this medication.

Individuals are monitored very closely while on ziconotide. If a person on ziconotide experiences suicidal thoughts, a health care provider should be contacted immediately.