ziconotide acetate at a glance
Medicine class
N-type calcium-channel blocker and non-opioid analgesic
Licensed use
Severe, chronic pain in adults requiring intrathecal analgesia
Administration
Infusion into spinal fluid through an implanted or external pump
Specialist oversight
Started and managed by clinicians experienced in intrathecal treatment
What is ziconotide acetate used for?
The selected UK product is licensed for:
Severe, chronic pain in adults who require intrathecal analgesia.
How does ziconotide acetate work?
Ziconotide blocks N-type calcium channels on pain-transmitting nerve endings in the spinal cord. This reduces calcium entry and the release of neurotransmitters involved in spinal pain signalling. It does not act at opioid receptors.
ziconotide acetate preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 100 micrograms/mL
How to take ziconotide acetate
Ziconotide is not swallowed or self-injected. It is delivered through an intrathecal catheter connected to an accurate external or implanted pump. Preparation, pump filling and adjustments are handled by trained professionals.
Follow the specialist team's instructions for pump and catheter care.
Check an external catheter entry site regularly for redness, swelling, pain or discharge.
Contact the clinical team immediately if external tubing becomes disconnected; do not reconnect it yourself.
ziconotide acetate side effects
Common or expected effects
- Confusion, dizziness or sleepiness
- Memory problems or headache
- Blurred vision or uncontrolled eye movements
- Nausea or vomiting
- Weakness or difficulty walking
Get urgent medical advice
- Suicidal thoughts, severe depression, hallucinations or psychosis
- Markedly reduced consciousness, coma or seizures
- Meningitis or another serious catheter-related infection
- Severe allergic reaction
- Muscle breakdown, particularly with weakness, pain or dark urine
ziconotide acetate in pregnancy
Human pregnancy information is absent or very limited, and animal studies found reproductive toxicity. Ziconotide is not recommended during pregnancy or for people who could become pregnant and are not using contraception. Specialist review is needed when pregnancy is planned or suspected.
ziconotide acetate while breastfeeding
It is unknown whether ziconotide or its breakdown products enter human milk, and risk to the infant cannot be excluded. The specialist and patient must decide between breastfeeding and treatment after considering the benefits of each.
ziconotide acetate interactions
Interaction studies are limited. Important combinations include:
Intrathecal chemotherapy
Concomitant use is contraindicated.
Intrathecal morphine
The combination may increase confusion, hallucinations, paranoid reactions, walking problems and other adverse effects, requiring close specialist supervision.
Baclofen, clonidine, bupivacaine or propofol
Systemic use with ziconotide has been associated with more sleepiness, so simultaneous use is discouraged.
Common questions about ziconotide acetate
Answers are fully visible for fast scanning and source review.
Is ziconotide acetate an opioid?
No. It blocks N-type calcium channels and does not act at opioid receptors.
Can ziconotide acetate be taken by mouth?
No. The selected UK product is a solution for intrathecal infusion and is not an oral preparation.
Can I adjust a ziconotide acetate pump myself?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.