Ziconotide is not a substrate, inhibitor of inducer of CYP enzymes. Risk for gastrointestinal adverse events in the form of nausea, vomiting, diarrhoea, reduced appetite and anorexia motivates vigilance against insufficient intake of food, especially of carbohydrate.

Ziconitide is a peptide.

Ziconotide is indicated for the treatment of severe, chronic pain in adults who require intrathecal (IT) analgesia. Very common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are nausea and vomiting. Other common side effects are diarrhoea, upper abdominal pain, reduced appetite and anorexia, myalgia and arthralgia.

Ziconotide is expected to be proteolytic cleaved by peptidases and proteases and degraded to peptide fragments and its individual constituent free amino acids. It is not listed as a substrate, inhibitor or inducer of any CYP enzymes.