Are you suffering from pain that is so severe that you can't even imagine? Maybe it's back pain, cancer pain, or nerve pain. Usually, it's very difficult to control such severe pain with painkillers like Panadol and ibuprofen. Sometimes, even if strong painkillers are given, some people have more side effects. So, today we are going to talk about a special medicine that doctors turn to when all other treatments fail. That is the Ziconotide injection.
Simply put, what is Ziconotide?
Ziconotide is a special medication used to treat severe, chronic pain . It's not like a regular painkiller. Normally, a pill we take when we have pain works by going to the site of the pain in the body. But Ziconotide works in a different way.
Simply put, when we feel pain in our body, it is when a signal travels from the pain site to the brain through the nerves. What Ziconotide does is block these pain signals that travel through the spinal cord to the brain . It is as if the pain message is stopped halfway before it reaches the brain. This is why it can control even severe pain that other medications cannot control.
Most importantly, this is only given when all other painkillers have failed or their side effects are intolerable, and under the strict supervision of a specialist.
How is this medicine given? Is this a regular injection?
No. This is not a shot like we usually get in the shoulder or buttock. This is given in a very special way.
This medicine is injected directly into the fluid around your spine (cerebrospinal fluid) . This is called an intrathecal injection. Because it is difficult to give this injection every day, doctors will implant a special pump (implantable pump) under your skin, usually in your abdomen.
This pump is like a small computer. It can release medicine at a specific time, at a specific dose. The doctor programs this pump and refills it at specific intervals. The medical team will also teach you how to use this pump.
Why such a complicated system?
This method is used because the drug needs to go directly to the nervous system. Otherwise, if it is given into the bloodstream as usual, it will be less effective and have more side effects.
Things you need to tell your doctor before starting treatment
Because this is a very powerful medication, it is important to tell your doctor about your complete health history before starting treatment. Be sure to tell them if you have any of the following conditions:
- Mental health issues: Have you ever had a condition like depression, anxiety, psychosis , or have you or someone in your family ever attempted suicide?
- Bleeding disorders: Do you have a problem with your blood not clotting easily?
- Infections: Tell us about any current infections in your body, especially infections involving the spine.
- Spinal canal blockage: Has a doctor ever told you about a spinal canal blockage?
- Allergies: If you have an allergy to this ziconotide medicine or any other medicine, food, or dye.
- Pregnancy: If you are pregnant, trying to get pregnant, or breastfeeding, be sure to let your doctor know.
What are the possible side effects of taking this medicine?
Like any medicine, ziconotide can cause side effects. Some are serious, some are common. It is important to be aware of these.
| Side effects and what to do | |
|---|---|
| Serious side effects that should be reported to your medical team immediately | |
| Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Mental and behavioral changes | Severe restlessness, agitation, confusion, seeing or hearing things that are not real (hallucinations), suicidal thoughts, increased depression. |
| Symptoms of Meningitis | Fever, stiff neck, difficulty looking at light, severe headache, nausea, and vomiting. (These may be signs of an infection in the brain or spinal cord). |
| Muscle damage (Rhabdomyolysis) | Unusual weakness, muscle pain, dark yellow or brown urine, decreased urine output. |
| Difficulty thinking and remembering | Difficulty concentrating, memory loss, difficulty speaking. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Confusion | Mild confusion. |
| Dizziness | Dizziness, loss of balance. |
| Nausea | Coming to vomit. |
| Inability to control the eyes | Uncontrollable eye movements. |
Special points to be careful of
Alcohol and other drugs
Do not drink alcohol while taking this medicine for any reason . Ziconotide can impair your alertness, balance, and reaction time. Drinking alcohol can make this condition more serious.
Also, you should be very careful when taking other medications that cause drowsiness (e.g., some cough syrups, allergy medications, sleeping pills). Tell your doctor about all the medications you take, even vitamins and herbal remedies.
Driving and operating machinery
Avoid driving or operating dangerous machinery until you know exactly how this medicine affects you. Also, to avoid dizziness or fainting, do not get up suddenly from a sitting or lying position. Get up slowly.
What if the dose increases?
Since this is given through a pump, the dose is usually not increased. However, if you suspect that you have taken too much medicine due to a pump malfunction or other reason, immediately contact the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Refill Appointments
Your doctor will give you a date to refill your pump with medication. Do not skip these dates. If for some reason you are unable to make it, call your medical team immediately and reschedule.
Take-Home Message
- Ziconotide is a powerful drug used only for very severe, chronic pain that has not responded to other treatments.
- This is delivered to the fluid surrounding the spinal cord through a special implantable pump implanted under the skin.
- You should tell your doctor about all your health conditions, especially mental health problems and allergies, before starting treatment.
- Seek immediate medical attention if you experience serious side effects such as confusion, behavioral changes, fever, and neck stiffness.
- Avoid drinking alcohol completely while taking this treatment. Be very careful when driving and operating machinery.
- If there is any change, increase, or new pain in your pain, let your doctor know.
👩🏽⚕️ Additional questions (FAQs)
💬 What is the Ziconotide / Prialt vaccine used for?
This is not an ordinary painkiller! This is an extremely powerful (Non-opioid) medicine that is administered in a hospital through an 'Intrathecal pump' installed by a doctor inside the patient's spinal cord/spinal cord to eliminate 100% of the unbearable 'Severe Chronic Pain' that is not relieved by even the strongest medicine (Morphine) for cancer patients, those with severe neurological disorders!
💬 What is this drug (Ziconotide) made of, which is stronger than morphine?
Amazing story! This medicine was discovered and made from the deadly poison (Conotoxin) produced by the 'extremely dangerous/poisonous snail (Conus magus / Cone snail)'! Once this poison reaches the spinal cord, it blocks/closes 100% of the calcium gates (N-type calcium channels) in the nerves that carry pain to the brain. This completely cuts off the pain message going to the brain.
💬 What are the most dangerous side effects of administering this special medicine to the spinal cord (Intrathecal)?
The side effects of this are extremely severe! (Black Box Warning). Because this drug goes directly to the brain/spinal cord, some patients develop unbearable schizophrenia/crazy (Hallucinations). Also, severe anxiety, paranoia, and devastating 'suicidal thoughts' occur immediately! The other biggest concern is that the patient has a high chance of not remembering anything (Cognitive impairment).
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