Ziconotide
Also known as Prialt, SNX-111, Omega-conotoxin MVIIA
Ziconotide is a synthetic version of a peptide toxin originally isolated from the venom of the marine cone snail Conus magus. It is approved as a prescription analgesic for severe chronic pain in patients who have not responded adequately to other treatments, including systemic opioids. Unlike opioid-based pain medications, it is not an opioid and carries no risk of respiratory depression or opioid-type dependence. It is administered exclusively by continuous intrathecal infusion under specialist supervision, typically via an implanted programmable pump. Because of its narrow therapeutic window and serious psychiatric and neurological risks, its use is restricted to specialized pain management centers.
Reported benefits
- Provides an opioid-free option for severe, treatment-refractory chronic pain
- Does not appear to cause tolerance or physical dependence with continued use
- Acts locally at the spinal cord, limiting some systemic side effects seen with oral analgesics
- Can be titrated and adjusted via a programmable intrathecal pump
How it works
Ziconotide selectively and reversibly blocks N-type voltage-gated calcium channels (Cav2.2) located on the presynaptic terminals of primary nociceptive afferent neurons in the dorsal horn of the spinal cord. By blocking calcium influx, it inhibits the release of pain-signaling neurotransmitters such as substance P and glutamate, interrupting pain transmission at the spinal level. This action is independent of opioid receptors, which is why it does not produce tolerance or physical dependence in the way opioids do.
Dosing ranges
| Tier | Dose | Frequency |
|---|---|---|
| Low | 2.4 mcg | per day (initial infusion rate, intrathecal) |
| Moderate | 9.6 mcg | per day (typical maintenance range, intrathecal) |
| High | 21.6 mcg | per day (maximum recommended, intrathecal) |
Estimate your dose
Dose estimator
Educational estimate for Ziconotide, scaled to body size. Not medical advice.
Read before using
This tool produces a rough, educational estimate by scaling commonly-published research ranges to lean body mass. It is not a prescription, medical advice, or a substitute for a licensed clinician. Most peptides use fixed dosing, not weight-based dosing. Individual needs vary. You are solely responsible for how you use this information.
Mixing & syringe units
Target dose follows the estimate above. Change it there, or edit it directly below.
Reconstitution calculator
How much water to add and how many insulin-syringe units to draw for Ziconotide. Educational only.
Draw to this mark
0.2units
= 0.002 mL for a 9.6 mcg dose
Concentration
5,000 mcg/mL
Doses per vial
1,041
Under 2 units is hard to measure accurately. Use less water for a larger, easier-to-read draw.
A U-100 syringe reads 100 units per mL. This is a reconstitution math helper only, not a prescription or dosing advice. Verify every calculation and consult a qualified healthcare provider.
Possible side effects
Common protocols
Common questions
What is Ziconotide used for?
Ziconotide is a synthetic version of a peptide toxin originally isolated from the venom of the marine cone snail Conus magus. It is approved as a prescription analgesic for severe chronic pain in patients who have not responded adequately to other treatments, including systemic opioids. Unlike opioid-based pain medications, it is not an opioid and carries no risk of respiratory depression or opioid-type dependence. It is administered exclusively by continuous intrathecal infusion under specialist supervision, typically via an implanted programmable pump. Because of its narrow therapeutic window and serious psychiatric and neurological risks, its use is restricted to specialized pain management centers. Reported benefits include provides an opioid-free option for severe, treatment-refractory chronic pain, does not appear to cause tolerance or physical dependence with continued use, acts locally at the spinal cord, limiting some systemic side effects seen with oral analgesics.
What is a typical Ziconotide dose?
Reported ranges run 2.4-21.6 mcg. A low protocol is 2.4 mcg per day (initial infusion rate, intrathecal), and a high protocol is 21.6 mcg per day (maximum recommended, intrathecal). This is reference information, not a dosing recommendation.
What is the half life of Ziconotide?
Approximately 4.6 hours in cerebrospinal fluid following intrathecal infusion. That is what sets the dosing frequency, and it is why the timing guidance is as directed by your clinician.
How is Ziconotide administered?
Intravenous: into a vein. Approved clinical administration is by continuous intrathecal infusion via an implanted pump; it must never be given intravenously, intramuscularly, or epidurally.
How long is a Ziconotide cycle?
Continuous intrathecal infusion with no defined on-cycle; dose adjustments are made gradually over weeks on, followed by Not cycled off; discontinuation requires slow downward titration to avoid rebound pain, not abrupt stopping off. Titration is slow and conservative, typically no more than 2.4 mcg/day increases up to twice weekly, to minimize psychiatric and neurological side effects.
What are the side effects of Ziconotide?
Reported side effects include significant risk of psychiatric symptoms, including hallucinations, confusion, and mood changes, cognitive impairment and memory problems, dizziness, nausea, and gait disturbance, elevated creatine kinase levels, requires an implanted intrathecal pump, carrying procedural and device-related risks. Evidence level for this compound is well studied.
Partner offer · $20 off
When did you last
check your blood work?
Regular blood work catches changes early. At-home collection with free pickup, 50+ biomarkers, and results in 72 hours.
- 1Order your kitTakes two minutes online, $20 off with this link.
- 2Collect at homePainless draw with free home pickup, no lab visit.
- 3Results in 72 hours50+ biomarkers with clear optimal ranges.
Partner offer · opens rythm.health
Educational use only, not medical advice. This profile is provided for research and educational purposes. Ziconotide may be a research compound or a prescription medication; nothing here is intended to diagnose, treat, cure, or prevent any disease. Dosing figures reflect commonly-published research ranges, not a prescription. Consult a qualified healthcare provider before making any health decision. Read the full disclaimer →