Ziconotide

Is Ziconotide safe?

Boxed warning; frequent psychiatric events

The boxed warning covers severe psychiatric symptoms. These are confusion, hallucinations, depression with suicidal thoughts, and paranoia. It also covers neurological impairment. This means decreased alertness, memory problems and unsteadiness. The drug is barred in anyone with a history of psychosis. The JAMA trial used rapid titration. Adverse events were frequent. About half had dizziness. Others had nausea, confusion, odd gait and trouble passing urine. 31 percent of ziconotide patients had serious adverse events. On placebo it was 10 percent. ¹²

Blood creatine kinase is a muscle enzyme. It rises in about 40 percent of patients and should be monitored. There are rare reports of muscle breakdown. Meningitis is a risk from the pump and catheter, not from the drug. Doctors can stop ziconotide abruptly without withdrawal. That is one practical advantage over intrathecal opioids. ²

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Reference information only, not medical advice. Drawn from the Ziconotide article, fact-checked against the cited sources. No dosing anywhere on this site.