Peptide profile
Ziconotide (MVIIA ω-conotoxin)
Conotoxin analog for intractable pain
Compare Ziconotide (MVIIA ω-conotoxin) with other peptides →Summary
A medicine from sea snails for very bad pain, given near the spine.
- Typical dose
- 2.4-6.0 mcg/day Continuous via intrathecal pump
- Cycle length
- Ongoing
- Evidence
- Animal data
Mechanism
How it works
Ziconotide acts like a roadblock for pain signals — it clogs the calcium channels that pain nerves need to fire, stopping the pain message at the spinal cord.
Ziconotide is a synthetic ω-conotoxin that selectively blocks N-type calcium channels in spinal cord, preventing pain neurotransmitter release (substance P, CGRP).
Reported in research
Benefits
- Strong pain relief that is not an opioid
- Works for really bad, long-lasting pain
- It is not addictive and your body won't need more
- Used when other pain medicines stop working
Context, not a prescription
Dosing
- Typical range
- 2.4-6.0 mcg/day Continuous via intrathecal pump
- Cycle length
- Ongoing
Safety
Side effects & contraindications
Possible side effects
- Dizziness
- Nausea
- Confusion
- Nystagmus (eye twitching)
- Psychosis
- Hallucinations
- Suicidal ideation
- Severe cognitive impairment
Contraindications
- Psychiatric disorders
- Pregnancy
- Severe renal/hepatic impairment
Research information, not medical advice. Always consult a licensed clinician before considering any peptide.
In depth
Full profile
What it does
It cuts down very bad long-lasting pain in people that opioids could not help.
How it works
Ziconotide works like a roadblock for pain. It plugs the little doors that pain nerves need to fire. This stops the pain message right at the spine.
It sticks tightly to tiny doors on nerves called N-type calcium channels. This stops nerves from passing along pain signals.
What to expect
It works right after it goes in near the spine.
- Hours to days: Pain starts to ease (the dose is adjusted slowly).
- Weeks 1-4: Steady pain relief with the pump.
- Ongoing: Keeps working over time, and your body never needs more.
Good to know
- Only used in a spine pump by a special doctor
- Watch how your mind and mood are doing closely
- Raise the dose slowly
Staying safe
- Feeling dizzy
- Feeling sick to your stomach
- Feeling confused
- Eyes twitching on their own
Avoid if you have:
- People with mental health problems
- Pregnant women
- People with bad kidney or liver problems
Mechanism of action
Ziconotide is a synthetic ω-conotoxin that selectively blocks N-type calcium channels in spinal cord, preventing pain neurotransmitter release (substance P, CGRP).
Binds with high affinity to N-type voltage-gated calcium channels (CaV2.2), inhibiting neurotransmitter release from primary afferent neurons.
Pharmacodynamics
Immediate post-intrathecal administration.
Severe chronic pain reduction in patients resistant to opioids.
Timeline
- Hours to days: Initial pain relief (requires dose titration).
- Weeks 1-4: Stable pain control with pump.
- Ongoing: Long-term maintenance without opioid tolerance.
Comparisons
- Ziconotide — effectiveness High, safety Fair, cost $$$$, Very Hard to use
- Morphine (intrathecal) — effectiveness High, safety Good, cost $$$, Hard to use
Adverse effects
Common:
- Dizziness
- Nausea
- Confusion
- Nystagmus (eye twitching)
Rare:
- Psychosis
- Hallucinations
- Suicidal ideation
- Severe cognitive impairment
Contraindications & risk mitigation
Contraindicated in:
- Psychiatric disorders
- Pregnancy
- Severe renal/hepatic impairment
- Only in intrathecal pump by specialist
- Monitor mental status closely
- Titrate slowly
Qué hace
Reduce el dolor muy intenso y prolongado en personas a las que los opioides no les ayudaban.
Cómo funciona
La ziconotide funciona como un bloqueo para el dolor. Tapa las pequeñas puertas que los nervios del dolor necesitan para activarse. Esto detiene el mensaje del dolor justo en la columna vertebral.
Se adhiere firmemente a pequeñas puertas en los nervios llamadas canales de calcio de tipo N. Esto impide que los nervios transmitan señales de dolor.
Qué esperar
Actúa inmediatamente después de administrarse cerca de la columna vertebral.
- Horas a días: El dolor comienza a aliviarse (la dosis se ajusta lentamente).
- Semanas 1-4: Alivio constante del dolor con la bomba.
- Continuo: Mantiene su eficacia con el tiempo y tu cuerpo no desarrolla tolerancia.
Bueno saber
- Solo se usa en una bomba espinal administrada por un médico especialista
- Monitorear de cerca el estado mental y el ánimo
- Aumentar la dosis lentamente
Manteniéndose seguro
- Mareos
- Náuseas
- Confusión
- Movimientos involuntarios de los ojos
Evitar si tienes:
- Personas con problemas de salud mental
- Mujeres embarazadas
- Personas con problemas graves de riñón o hígado
Mecanismo de acción
La ziconotide es una ω-conotoxina sintética que bloquea selectivamente los canales de calcio de tipo N en la médula espinal, impidiendo la liberación de neurotransmisores del dolor (sustancia P, CGRP).
Se une con alta afinidad a los canales de calcio voltaje-dependientes de tipo N (CaV2.2), inhibiendo la liberación de neurotransmisores en las neuronas aferentes primarias.
Farmacodinamia
Inmediato tras la administración intratecal.
Reducción del dolor crónico severo en pacientes resistentes a opioides.
Cronología
- Horas a días: Alivio inicial del dolor (requiere titulación de la dosis).
- Semanas 1-4: Control estable del dolor con la bomba.
- Continuo: Mantenimiento a largo plazo sin tolerancia a opioides.
Comparaciones
- Ziconotide — efectividad Alta, seguridad Adecuada, costo $$$$, Muy difícil de usar
- Morfina (intratecal) — efectividad Alta, seguridad Buena, costo $$$, Difícil de usar
Efectos adversos
Comunes:
- Mareos
- Náuseas
- Confusión
- Nistagmo (movimientos involuntarios de los ojos)
Raros:
- Psicosis
- Alucinaciones
- Ideación suicida
- Deterioro cognitivo severo
Contraindicaciones y mitigación de riesgos
Contraindicado en:
- Trastornos psiquiátricos
- Embarazo
- Insuficiencia renal/hepática severa
- Solo mediante bomba intratecal administrada por un especialista
- Monitorear el estado mental de cerca
- Titular la dosis lentamente
Reference data
Specifications
- Cycle length
- Ongoing
FAQ
Common questions
Is Ziconotide addictive?
No, it is a non-opioid and has no abuse potential.
Can it be injected subcutaneously?
No, only intrathecal (into spinal fluid). Systemic administration does not work.
What is the evidence level?
This compound is classified as Animal data. Most data comes from preclinical animal studies. Human clinical trial evidence is limited or absent.
Research
Research & sources
Current evidence for Ziconotide (MVIIA ω-conotoxin) is rated as Animal data. Research is based primarily on animal models.
- 1. Ziconotide chronic pain (2006) — DOI:10.1016/S1474-4422(06)70455-3
- 2. Conotoxins review (2009) — DOI:10.1111/j.1526-4637.2009.00672.x
- 3. Ziconotide chronic pain (2006)
- 4. Conotoxins review (2009)