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Ziconotide: an update and review.

Jason A Williams¹, Miles Day, James E Heavner

¹Texas Tech University Health Sciences Center, 3601 Fourth Street, MS 818, Lubbock, TX 79430, USA.

Expert Opinion on Pharmacotherapy

|June 4, 2008

Summary

Ziconotide is an N-type calcium channel blocker for severe chronic pain. This review covers its safety, efficacy, and dosing for intrathecal infusion therapy.

Area of Science:

Pharmacology
Neurology
Pain Management

Background:

Ziconotide is the sole FDA-approved N-type calcium channel blocker for chronic pain.
Indicated for severe chronic pain unresponsive to other treatments, requiring intrathecal therapy.

Purpose of the Study:

To review safety, efficacy, and dosing information for ziconotide.
Provide a comprehensive overview for healthcare professionals.

Main Methods:

Literature search from 1980 to January 2008.
Databases searched: PubMed, MEDLINE, PREMEDLINE.
Keywords used: ziconotide, conotoxins, pain.

Main Results:

Ziconotide blocks nociceptive signals via intrathecal infusion.

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It's a synthetic peptide (omega conotoxin MVIIA) from Conus magus venom.

Characterized by high potency, steep dose-response, slow onset, and narrow safety margin.

Conclusions:

Ziconotide requires careful management by experienced physicians.
Intrathecal infusion necessitates convenient access to medical facilities.
Slow response to dose adjustments requires patient monitoring.