Peptide Schedule
Ziconotide (Prialt)25 residuesCKGKGAKCSRLMYDCCTGSCRSGKCEach bubble = one amino acid. Size = residue mass. Color = chemical class.Ziconotide (Prialt) Dosage Calculator
Ziconotide is a synthetic 25-amino-acid peptide identical to omega-conotoxin MVIIA, a naturally occurring toxin found in the venom of the Pacific marine cone snail Conus magus.
2.4mcg · Daily
Summary: Add 0mL BAC water to your 1mg vial. Draw to < 0.1 units on a U-100 syringe for a 2.4mcg dose. This vial will last 0 doses.
Cycle Planner
Ziconotide (Prialt) Pharmacokinetics
Pharmacokinetics — Active Dose Over Time
t½ = ~4.6 hours (CSF); ~1.3 hours (serum)Disclaimer: This curve is a simplified first-order exponential decay model. Actual pharmacokinetics vary based on injection site, individual metabolism, body composition, and other factors. Half-life values are approximate and based on available preclinical and clinical literature. Many research peptides lack formal human pharmacokinetic studies. This is for educational purposes only — not medical advice.
Ziconotide (Prialt) Dosing Protocol
| Level | Dose / Injection | Frequency |
|---|---|---|
| Beginner | 2.4mcg | Daily |
| Moderate | 9.6mcg | Daily |
| Aggressive | 19.2mcg | Daily |
Note: Ziconotide is an FDA-approved non-opioid analgesic delivered exclusively via continuous intrathecal infusion using an implanted or external microinfusion pump. It is NOT suitable for subcutaneous, intravenous, or epidural administration. Supplied as a pre-filled solution (25 mcg/mL or 100 mcg/mL) — no reconstitution with bacteriostatic water is needed. Dosing in the calculator reflects total daily intrathecal infusion in mcg/day (delivered continuously over 24 hours, not as a single bolus). The recommended starting dose is 2.4 mcg/day (0.1 mcg/hour), with slow upward titration of no more than 2.4 mcg/day increases, no more frequently than 2-3 times per week, up to a maximum of 19.2 mcg/day (0.8 mcg/hour). BLACK BOX WARNING: Severe psychiatric symptoms and neurological impairment may occur. This is a prescription medication that must be administered under direct medical supervision by a physician experienced with intrathecal drug delivery systems.
About Ziconotide (Prialt)
Ziconotide is a synthetic 25-amino-acid peptide identical to omega-conotoxin MVIIA, a naturally occurring toxin found in the venom of the Pacific marine cone snail Conus magus. First approved by the FDA in December 2004 under the brand name Prialt, it represents the first-in-class selective N-type voltage-gated calcium channel (Cav2.2) blocker approved for clinical use. It is indicated for the management of severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatment options, including systemic analgesics, adjunctive therapies, and intrathecal morphine.\n\nThe drug works by selectively and reversibly binding to N-type voltage-gated calcium channels (Cav2.2) located on primary afferent nociceptive nerve terminals in the superficial layers (laminae I and II) of the dorsal horn of the spinal cord. By blocking calcium influx through these channels, ziconotide prevents the release of pro-nociceptive neurotransmitters — including glutamate, calcitonin gene-related peptide (CGRP), and substance P — thereby interrupting pain signal transmission at the spinal level. Unlike opioids, ziconotide does not bind to opioid receptors and does not produce tolerance, physical dependence, or respiratory depression.\n\nThree pivotal randomized, double-blind, placebo-controlled trials established its efficacy. Study 301 (Rauck et al., 2006) demonstrated statistically significant pain reduction in 220 patients with severe chronic pain (14.7% vs 7.2% improvement; P=0.036) with a slow titration protocol. Study 96-002 (Wallace et al., 2006) showed a 31.2% mean reduction in pain scores versus 6.0% for placebo in 255 patients with chronic nonmalignant pain using a rapid titration. A long-term open-label extension (Wallace et al., 2008) with 644 patients demonstrated sustained efficacy over 350 patient-years of exposure.\n\nZiconotide carries a Black Box Warning for severe psychiatric symptoms and neurological impairment, including cognitive impairment, hallucinations, psychosis, and changes in mood or consciousness. It is contraindicated in patients with a preexisting history of psychosis. Depression with risk of suicide has been reported. Despite these serious warnings, ziconotide fills a critical therapeutic niche as a non-opioid option for patients with the most severe, refractory chronic pain — particularly those who have failed or cannot tolerate intrathecal opioids.