Peptide LibraryZiconotide dosage in published studies and labels
These are the doses used for Ziconotide in FDA labelling and published clinical studies, reported as each source states them, one row per regimen. They describe what was studied or approved for a specific population. They are not a recommendation, and none of them is a dose for any individual.
Research and educational reference only. This is not medical advice, and no figure on this page is a dosing recommendation.
Last checked against primary sources:
Studied regimens and sources
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.