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Intrathecal Pharmacology Update: Novel Dosing Strategy for Intrathecal Monotherapy Ziconotide on Efficacy and Sustainability

Intrathecal drug delivery is a well‐defined strategy to treat malignant and nonmalignant pain. Ziconotide is a well‐studied intrathecal medicine option that has many attractive qualities, as it is non‐granulomagenic, overdose or underdose is not associated with cardiopulmonary compromise or death, and is a non‐opoid analgesic. However, it has had slow adoption into pain care algorithms because it has been historically plagued with the connotation of having a narrow therapeutic window and a low sustainability rate. We introduce a novel dosing strategy to improve patient outcomes and sustainability.