Medical Editor: John P. Cunha, DO, FACOEP
What Is Prialt?
Prialt (ziconotide) is a non-narcotic pain reliever used to treat severe chronic pain in people who cannot use or do not respond to standard pain-relieving medications.
What Are Side Effects of Prialt?
Common side effects of Prialt include:
- dizziness,
- spinning sensation,
- drowsiness,
- nausea,
- headache,
- weakness,
- joint pain,
- sleep problems,
- unusual dreams,
- stomach pain,
- diarrhea,
- constipation,
- loss of appetite,
- urinating less than usual, or
- loss of balance or coordination
Dosage for Prialt
The dose of Prialt is determined by a physician and it is administered in a clinical setting.
What Drugs, Substances, or Supplements Interact with Prialt?
Prialt may interact with other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety), or diuretics (water pills). Tell your doctor all medications you use.
Prialt During Pregnancy and Breastfeeding
Prialt should be used only when prescribed during pregnancy. It is unknown if this medication passes into breast milk, and it is unlikely to harm a nursing infant. Consult your doctor before breastfeeding.
Additional Information
Our Prialt (ziconotide) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

SLIDESHOW
Back Pain: 16 Back Pain Truths and Myths See SlideshowGet emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Ziconotide can affect your central nervous system and you may feel less alert. A person caring for you should seek emergency medical attention if you are hard to wake up.
Call your doctor at once if you have:
- new or worsening muscle pain, soreness, or weakness, and/or dark urine;
- a light-headed feeling (like you might pass out);
- strange sensations in your mouth;
- skin sores, itching, blisters, breakdown of the outer layer of skin;
- confusion (especially in older adults);
- problems with memory or thought;
- unusual changes in mood or behavior--anger, aggression, paranoia, hallucinations, racing thoughts, risk-taking behavior;
- symptoms of depression--feelings of low self-worth, loss of interest in things you once enjoyed, new sleep problems, thoughts about hurting yourself; or
- symptoms of meningitis--fever, headache, neck stiffness, increased sensitivity to light, nausea, vomiting, confusion, or drowsiness.
Common side effects may include:
- dizziness;
- confusion;
- nausea; or
- unusual or involuntary eye movements.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

QUESTION
Medically speaking, the term "myalgia" refers to what type of pain? See AnswerSIDE EFFECTS
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates in clinical practice.
A total of 1254 adult patients received PRIALT as a continuous infusion in acute and severe chronic pain trials with an exposure of 662 patient-years. The mean duration of treatment was 193 days with 173 patients (14%) treated for at least 1 year. The average final dose was 17.6 mcg/day (0.73 mcg/hr).
The most frequently reported adverse reactions (≥ 25%) in clinical trials were dizziness, nausea, confusional state and nystagmus. Slower titration of PRIALT may result in fewer serious adverse reactions and discontinuation of PRIALT for adverse reactions [see Clinical Studies and DOSAGE AND ADMINISTRATION].
Adverse reactions during the slow titration placebo-controlled trial that occurred in 5% or greater of patients and more commonly with PRIALT than with placebo are summarized in Table 1.
Table 1: Incidence of Adverse Reactions in Slow Titration Placebo-Controlled Trial by Percent (Events That Occurred in ≥ 5% of Patients and More Commonly with PRIALT than with Placebo)
MedDRA System Organ ClassMed DRA Preferred term | PRIALT N=112 | Placebo N=108 |
Percentage of Patients | ||
Any AE | 93 | 82 |
Ear and Labyrinth Disorders | ||
Vertigo | 7 | 0 |
Eye Disorders | ||
Vision Blurred | 12 | 3 |
Gastrointestinal Disorders | ||
Diarrhea | 18 | 15 |
Nausea | 40 | 29 |
Vomiting | 16 | 14 |
General Disorders and Administration Site Conditions | ||
Asthenia | 18 | 6 |
Gait Abnormal | 14 | 2 |
Pyrexia | 5 | 3 |
Rigors | 7 | 5 |
Infections and Infestations | ||
Sinusitis | 5 | 2 |
Metabolism and Nutrition Disorders | ||
Anorexia | 6 | 2 |
Musculoskeletal and Connective Tissue Disorders | ||
Muscle Spasms | 6 | 4 |
Pain in Limb | 5 | 2 |
Nervous System Disorders | ||
Amnesia | 8 | 0 |
Ataxia | 14 | 1 |
Dizziness | 46 | 13 |
Dysarthria | 7 | 0 |
Dysgeusia | 5 | 5 |
Headache | 13 | 11 |
Memory Impairment | 7 | 1 |
Nystagmus | 8 | 0 |
Somnolence | 17 | 10 |
Tremor | 7 | 3 |
Psychiatric Disorders | ||
Anxiety | 8 | 3 |
Confusional State | 15 | 5 |
Insomnia | 6 | 9 |
Renal and Urinary Disorders | ||
Urinary Retention | 9 | 0 |
Skin and Subcutaneous Disorders | ||
Pruritis | 7 | 7 |
Sweating Increased | 5 | 6 |
Other Adverse Reactions Observed During Clinical Studies Of PRIALT
The following adverse reactions assessed as related to PRIALT have been reported in 2% or greater of patients participating in the clinical studies:
EYE DISORDERS: diplopia, visual disturbance
GASTROINTESTINAL DISORDERS: abdominal pain, constipation, dry mouth, nausea aggravated
GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS: fall, fatigue, lethargy, edema peripheral
INVESTIGATIONS: blood creatine phosphokinase increased
METABOLISM AND NUTRITION DISORDERS: appetite decreased
MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS: muscle cramp, muscle weakness, myalgia, pain in limb
NERVOUS SYSTEM DISORDERS: aphasia, areflexia, balance impaired, burning sensation, coordination abnormal, disturbance in attention, dizziness postural, dysarthria, dysgeusia, hypoaesthesia, mental impairment, paraesthesia, sedation, speech disorder
PSYCHIATRIC DISORDERS: agitation, anxiety, cognitive disorder, confusional state, depression, depression aggravated, disorientation, hallucination, hallucination auditory, hallucination visual, insomnia, irritability, mood disorder, nervousness, paranoia
RENAL AND URINARY DISORDERS: dysuria, urinary hesitation
VASCULAR DISORDERS: hypotension, orthostatic hypotension.
The following medically important adverse reactions occurred in less than 2% of patients were assessed by the clinical investigators as related to PRIALT: acute renal failure, atrial fibrillation, cerebrovascular accident, sepsis, meningitis, psychotic disorder, suicidal ideation, respiratory distress, rhabdomyolysis, electrocardiogram abnormal, stupor, loss of consciousness, clonic convulsion and grand mal convulsion. Fatal aspiration pneumonia and suicide attempt were reported in less than 1% of patients.
Postmarketing Experience
The following adverse events have been reported during post-approval use of PRIALT. Because these events are reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency or establish a causal relationship to drug exposure: Hypersensitivity reactions including angioedema, serious skin reactions including bullous dermatitis, skin ulcers, skin exfoliation, and burning skin sensation.
Read the entire FDA prescribing information for Prialt (Ziconotide)
© Prialt Patient Information is supplied by Cerner Multum, Inc. and Prialt Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.
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