Nonnarcotic analgesics:

Indications for PRIALT:

Management of severe chronic pain in patients for whom intrathecal therapy is warranted and who are intolerant of or refractory to other treatment (eg, systemic analgesics, adjunctive therapies, intrathecal morphine).


Give by intrathecal infusion using appropriate microinfusion device and procedures. Individualize; see literature. Initial: up to 2.4mcg/day (0.1microgram/hr); titrate in increments of up to 2.4mcg/day (0.1mcg/hr) at intervals of up to 2–3 times per week; max 19.2mcg/day (0.8mcg/hr) by day 21.


Not recommended.


History of psychosis. Inj site infections. Uncontrolled bleeding diathesis. Spinal canal obstruction.

Boxed Warning:

Neuropsychiatric adverse reactions.


Risk of severe psychiatric symptoms and neurological impairment. Monitor for signs/symptoms of meningitis and other infections. Discontinue if infection, cognitive impairment, hallucinations, mood changes, or impaired consciousness occur. Reduce dose or discontinue if myasthenias, myalgia, or persistent increases in serum creatine kinase occur. Hepatic or renal impairment. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.

Pharmacologic Class:

Analgesic (non-opioid N-type calcium channel blocker).


Concomitant intrathecal opiates: not recommended. CNS effects potentiated by other CNS depressants, antiepileptics, neuroleptics, diuretics; discontinue ziconotide if occurs.

Adverse Reactions:

Dizziness, GI upset, fever, headache, somnolence, nystagmus, asthenia, ataxia, abnormal vision, dysesthesia, parasthesia, urinary retention, psychiatric effects (eg, hallucinations, mania), cognitive/memory impairment (eg, confusion, aphasia, stupor), worsening depression/suicidal ideation.

How Supplied:

Soln single-use vial; 25mcg/mL (20mL)—1; 100mcg/mL (1mL, 5mL)—1

Pricing for PRIALT

20ml of 25mcg/ml vial (Qty: 1)
Appx. price $4454