Peptide LibraryZiconotide
Ziconotide is a research peptide in the Calcium Channel Blocker class. Ziconotide is a 25-amino-acid omega-conotoxin that selectively blocks N-type voltage-gated calcium channels on primary nociceptive afferents in the dorsal horn of the spinal cord. Blocking calcium influx prevents release of pain-signalling neurotransmitters.
For research use only.
Key Facts
- CAS
- —
- Molecular Weight (MW)
- 2639.2 g/mol
- Half-life
- About 4.6 hours in cerebrospinal fluid after intrathecal dosing; 1.3 hours in serum
- FDA status
- Approved
- Evidence level
- FDA Approved
- Human dose established
- Yes
- Administration Route
- Intrathecal
- Frequency
- Continuous intrathecal infusion
- Last updated
- Nov 7, 2026
- Reviewed
- Nov 7, 2026
Research summary
Synthetic equivalent of a cone snail venom peptide, approved for severe chronic pain in adults for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments.
Research evidence
- Regulatory review (FDA label)1 reviewed source
- Controlled human trialsNone in reviewed sources
- Early or uncontrolled human studiesNone in reviewed sources
- Lab & animal studiesNone in reviewed sources
How it works
Each step shows whether the sources Peptide Library has reviewed include that kind of research. Counts are reviewed sources, not every study ever published. Reviews and programme summaries that describe human use are shown as "reported", not as trials, and registered trials without published results are listed but not counted. A higher step means research has progressed further; it does not mean a compound works better or is safer. Compounds whose evidence has not been reviewed yet show "Not reviewed" instead of a guess.
Peptide Library's Ziconotide profile summarises 5 cited studies listed in the Science section, the compound's regulatory status, and research-protocol parameters reported for it. It is a research reference, not medical advice.
Ziconotide dosage evidence
Ziconotide has an FDA-approved human dosage, as Prialt, only as a continuous intrathecal infusion through an implanted or external microinfusion pump for adults with severe chronic pain who need intrathecal therapy and cannot tolerate or did not respond to other treatments. The label starts at no more than 2.4 mcg a day and allows increases of up to 2.4 mcg a day two to three times a week, to a recommended maximum of 19.2 mcg a day.
| Human dosing established | Yes |
|---|---|
| Studied dose range | 2.4–19.2 mcg per day by intrathecal infusion (FDA label) |
| Route | Intrathecal |
| Frequency | Continuous intrathecal infusion |
| Duration studied | Ongoing; in the label's schedule the recommended maximum is reached by day 21 |
| Titration | Start at no more than 2.4 mcg/day (0.1 mcg/hour); increase by up to 2.4 mcg/day at intervals of no more than 2–3 times a week, to a recommended maximum of 19.2 mcg/day (0.8 mcg/hour) by day 21. |
| Half-life | About 4.6 hours in cerebrospinal fluid after intrathecal dosing; 1.3 hours in serum |
| Evidence level | FDA Approved |
| Last reviewed | 2026-11-07 |
Research-reported dosing
Doses as studied, one row per regimen. Different trials used different regimens; they are listed separately rather than averaged.
| Study / context | Population | Dose | Route | Frequency | Duration | Outcome studied | Source |
|---|---|---|---|---|---|---|---|
| FDA label — Prialt, severe chronic painFDA-approved label · FDA prescribing information | Adults with severe chronic pain for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments | Start at no more than 2.4 mcg/day (0.1 mcg/hour); recommended maximum 19.2 mcg/day (0.8 mcg/hour) | Intrathecal, by programmable implanted or external microinfusion device | Continuous | Titrated to response and adverse events | In a 21-day placebo-controlled trial with this slow titration, pain scores improved by 12% on average versus 5% with placebo; the final mean dose was 6.9 mcg/day | PRIALT (ziconotide) intrathecal infusion (Esteve Pharmaceuticals) — FDA prescribing information, DailyMed |
Where sources disagree
- The label carries a boxed warning: severe psychiatric symptoms and neurological impairment can occur, patients must be monitored for cognitive impairment, hallucinations and changes in mood or consciousness, and it is contraindicated in people with a history of psychosis.
- It is not for intravenous use. The label notes that a faster titration used in earlier trials, up to 57.6 mcg/day within 5–6 days, was less well tolerated with substantially more adverse events. Safety and effectiveness in children have not been established.
Sequence & molecular data
| Molecular formula | C102H172N36O32S7 |
|---|---|
| Molecular weight | 2639.2 g/mol |
| PubChem CID | 16135415 |
| FDA UNII | 7I64C51O16 |
| ChEMBL | CHEMBL4594214 |
Identifiers link to the public PubChem, FDA Substance Registration (UNII), ChEMBL and DrugBank records for the same entity.
Science
Mechanism of Action
Ziconotide is a 25-amino-acid omega-conotoxin that selectively blocks N-type voltage-gated calcium channels on primary nociceptive afferents in the dorsal horn of the spinal cord. Blocking calcium influx prevents release of pain-signalling neurotransmitters. It does not act at opioid receptors, so it neither produces tolerance in the opioid sense nor is reversed by naloxone, and it must be delivered intrathecally because it does not cross the blood-brain barrier.
Studies
Research statistics
380 PubMed publications · 22.3% human clinical research · 11 registered trials
Counts of published research through 2026-11-01, not evidence that it works. Publications by year, study types and trials · How publications are counted
Regulatory & research status
Ziconotide is an FDA-approved product for specific labelled indications. Approval does not extend to the research contexts described on this page, and approved products are prescription medicines.
| FDA status | Approved |
|---|---|
| Research status | Approved product (see FDA status) |
| Availability | Prescription-Only |
| WADA (sport) | Unknown / Not Listed |
| Library classification | FDA-Approved |
How FDA approval, compounding and research-only status differ
Benefits
—
Ziconotide side effects
No side effects listed yet for this entry.
Storage & stability
This compound is not supplied as a powder to be mixed, so the freeze-dried powder and reconstitution handling described for research peptides does not apply. Storage conditions are product-specific: follow the label or packaging of the product itself.
Ziconotide: frequently asked questions
What is Ziconotide?
Synthetic equivalent of a cone snail venom peptide, approved for severe chronic pain in adults for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatments.
How does Ziconotide work?
Ziconotide is a 25-amino-acid omega-conotoxin that selectively blocks N-type voltage-gated calcium channels on primary nociceptive afferents in the dorsal horn of the spinal cord. Blocking calcium influx prevents release of pain-signalling neurotransmitters.
Is Ziconotide FDA approved?
Yes. Ziconotide is approved by the FDA, and approved products are prescription medicines. Approval is always for specific indications studied in clinical trials, so an approved status does not mean the compound is approved for every use it is discussed for. Research-chemical material sold under the same name is not the approved product.
What peptides are similar to Ziconotide?
Compounds most often compared with Ziconotide include Angiotensin II, Cetrorelix, Corticorelin and Cosyntropin. They are grouped by shared mechanism or research area rather than by equivalence, and their regulatory status and evidence base differ.
References
- A comprehensive review on ziconotide — Heliyon, 2024External reference
- Administering ziconotide and monitoring patients treated with ziconotide: expert opinions — Pain Manag Nurs, 2013External reference
- Ziconotide: a clinical update and pharmacologic review — Expert Opin Pharmacother, 2013External reference
- Ziconotide, 2006External reference
- Ziconotide, 2026External reference
Related research, comparisons & guides
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Compiled by Peptide Library Editorial · Reviewed Aug 30, 2026 · Updated Nov 7, 2026 · Version 2
This Ziconotide profile is compiled from published literature (5 cited studies linked above), public regulatory records and chemical registries. It describes what research reports; it is not medical advice, and nothing here is a dosing recommendation for humans. Peptide Library does not sell peptides. Editorial policy · How profiles are compiled · Report an error
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