ziconotide

Contraindicated in:

Hypersensitivity;
History of psychosis;
Infection at microinfusion injection site;
Uncontrolled bleeding;
Spinal cord obstruction;
Lactation: Can cause sedation and side effects in the infant.

Use Cautiously in:

History of suicidal ideation/psychiatric disorder;
Pedi: Safety not established;
OB: Pregnancy;
Geri: ↑susceptibility to adverse CNS effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: changes in BP

EENT: nystagmus, abnormal vision

GI: nausea, anorexia, vomiting

Local: catheter/injection site reactions

MS: hypertonia, urinary retention, ↑creatine kinase

Neuro: abnormal gait, ataxia, confusion, dizziness, drowsiness, headache, impaired memory, weakness, ↓alertness/responsiveness, aphasaia, cognitive impairment, hallucinations, memory impairment, MENINGITIS, psychiatric symptoms, speech disorder

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

↑risk of CNS depression with other CNS depressants including anticonvulsants, phenothiazines, antipsychotics, antihistamines, opioids, sedatives,or diuretics.

Availability ⬆ ⬇

Solution for intrathecal use: 25 mcg/mL; 100 mcg/mL

Route/Dosage ⬆ ⬇

IT (Adults ): up to 2.4 mcg/day initially (0.1 mcg/hr), may be gradually ↑ 2–3 times/wk in increments of 2.4 mcg/day up to a maximum of 19.2 mcg/day (0.8 mcg/hr) over 21 days.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Blocks spinal N-channel calcium channels, decreasing transmission of pain signals to the brain.
Has no effect on opioid receptors.

Therapeutic effects:

Decrease in severe pain.

Classifications ⬆ ⬇

Therapeutic Classification: analgesics

Pharmacologic Classification: insoluble complex

Pharmacokinetics ⬆ ⬇

Absorption: IT administration results in complete bioavailability in the CSF. Minimal plasma distribution.

Distribution: Distributes in entire CSF volume.

Metabolism/Excretion: Degraded by enzymes in tissues and fluids.

Half-Life: 4.6 hr (in CSF).

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
IT	rapid	2–3 days	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient on correct technique for care of equipment.
May cause dizziness and drowsiness. Caution patient to avoid driving and other activities requiring alertness until response to ziconotide is known.
Advise patient to avoid taking alcohol and other CNS depressants during ziconotide therapy. Consult health care professional prior to taking Rx, OTC, or herbal products during therapy.
Instruct patient and caregiver to contact health care professional immediately if changes in mental status (lethargy, confusion, disorientation, decreased alertness), changes in mood or perception (hallucinations, including unusual tactile sensations in oral cavity), symptoms of depression or suicidal ideation, or nausea, vomiting, seizures, fever, headache, or still neck occur; may be symptoms of developing meningitis.
Advise patient to consult health care professional if new or worsening muscle pain, soreness, or weakness with or without darkened urine occur.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

18860- Jazz Pharmaceuticals, Inc.
- 18860-720- Prialt
  - 18860-720-10- 1 VIAL, GLASS in 1 CARTON (18860-720-10) > 1 mL in 1 VIAL, GLASS

18860- Jazz Pharmaceuticals, Inc.
- 18860-722- Prialt
  - 18860-722-10- 1 VIAL, GLASS in 1 CARTON (18860-722-10) > 5 mL in 1 VIAL, GLASS

18860- Jazz Pharmaceuticals, Inc.
- 18860-723- Prialt
  - 18860-723-05- 1 VIAL, GLASS in 1 CARTON (18860-723-05) > 20 mL in 1 VIAL, GLASS

18860- Jazz Pharmaceuticals, Inc.
- 18860-723- Prialt
  - 18860-723-10- 1 VIAL, GLASS in 1 CARTON (18860-723-10) > 20 mL in 1 VIAL, GLASS

70720- TerSera Therapeutics LLC
- 70720-720- PRIALT
  - 70720-720-10- 1 VIAL, GLASS in 1 CARTON (70720-720-10) > 1 mL in 1 VIAL, GLASS

70720- TerSera Therapeutics LLC
- 70720-722- PRIALT
  - 70720-722-10- 1 VIAL, GLASS in 1 CARTON (70720-722-10) > 5 mL in 1 VIAL, GLASS

70720- TerSera Therapeutics LLC
- 70720-723- PRIALT
  - 70720-723-10- 1 VIAL, GLASS in 1 CARTON (70720-723-10) > 20 mL in 1 VIAL, GLASS

section name header

Indications ⬇

Contraind./Precautions ⬆ ⬇