IDD what, how, why?

what is idd therapy?

WHY USE IDD Therapy?

Intrathecal drug delivery is an effective way to manage cancer pain, with fewer side effects compared to oral medication.1,2

An implantable pump is connected to a thin, flexible tube that releases the pain medication directly into the fluid surrounding the spinal cord, in an area called the intrathecal space. Because Intrathecal drug delivery releases small amounts of medication, pain can be controlled with a fraction of the oral medication dose.3 Most people experience fewer or more tolerable side effects versus oral dosing.1 Intrathecal drug delivery may provide relief when other treatments - like oral medications ­- have not.

Intrathecal delivery

A key advantage of intrathecal drug delivery is that you can try it first and experience how the therapy may work for you. You’ll learn about this trial in the next few pages.


An IDD pump delivers prescribed amounts of pain medication directly into the fluid that surrounds the spinal cord. This area is called the intrathecal space. 

A surgeon places the IDD pump just under the skin of the abdomen. The pump is programmed wirelessly to release the amount of medicine as prescribed by your doctor. 

In some case, the pump maybe prescribe with a remote control that allow the patient to inject extra boluses of drugs if pain should arise. The amount of bolus and quantity of drug is predefined by the physician. The pump is CE marked for use with predetermined drugs and covered by private and public insurance companies across Europe.

whY USE idd therapy?


Many people can control pain well enough with oral medication, or injection therapy. However, some people find that these treatments don’t work well enough or have intolerable side effects. 


If treatments like pills or injections aren’t giving you enough relief from severe pain, talk to a specialist about a treatment option called intrathecal drug delivery.

This is an advanced drug delivery system which is implantable inside the body. It could be suitable for you if:

  • You aren’t getting enough pain relief from other treatments
  • You’re struggling with drug side effects like constipation, drowsiness, confusion and nausea4
Animated IDD infographic on blue background

Intrathecal drug delivery may provide relief when other treatments - like oral medications or injections - have not. It may give you greater comfort and control, allowing you to rethink what’s possible with your lifestyle and managing your condition.


At doses high enough to be effective for some patients, pain killers can cause side effects such as constipation, drowsiness, confusion or nausea.4

Because it is an intrathecal drug delivery system, the pain medication is delivered directly to the fluid flowing around the spine. When medicine is placed right where it is needed, you need less. Intrathecal drug therapy, therefore, may help minimise some of the possible side effects that may accompany pain medication.1


Like test driving a car, the trial allows you to “test drive” intrathecal drug delivery before committing to long-term therapy. The trial allows you to:

  • Assess how intrathecal drug delivery may relieve your pain during daily activities
  • Experience how it feels to receive pain medication targeted to the intrathecal space
  • Decide if you want to go ahead with an implant


Intrathecal drug delivery doesn’t cure the underlying disease, but it may help you better manage your cancer pain. Here’s what to expect:

  • Your physician may ask you to reduce or stop taking oral pain medications before the trial
  • Your physician will recommend the trial method that makes the most sense for your situation and discuss the risks of the procedure with you
  • After the trial, you and your physician will discuss your experience and decide if an implantable intrathecal drug delivery system is right for you

“When my pain finally went away, my smile came back.”



Intrathecal drug delivery allows you to take control of your pain by giving you the ability to manage breakthrough pain 3 times faster compared to conventional medication and receive pain relief with less systemic opioid side effects.1,2,5

Patient video thumbnail Sophie


Your pump will be programmed to deliver the exact dose you need and can even vary the amount of intrathecal pain medication at different times of day. Your doctor will select the regimen that suits best your needs.

Your doctor can decide to prescribe the optional myPTM™ personal therapy manager that allows you to activate delivery of physician-programmed supplemental doses of medication, this helps you manage unpredictable pain.


IDD therapy can be turned off by your doctor, or, if desired, the pump and catheter can be surgically removed.


Doctors have been prescribing IDD therapy since 1992, when it was approved by the FDA in the United States. The same Medtronic pump is also used to deliver pain medication for many patients worldwide.

WHAT IS SynchroMed™ II?

Synchromed device image on blue background

The SynchroMed™ II drug infusion pump is an implantable, battery-powered device that stores and dispenses medication inside the body. The pump delivers the medicine to the fluid around the spine through a thin, flexible tube called a catheter.

A doctor programs the pump to release a prescribed amount of medication.
Both the amount and timing can be adjusted by your doctor as your needs change.


The SynchroMed™ II is an advanced drug delivery system which has a range of features aimed at controlling your pain1,2

  • Programmed for your needs – Your doctor programs the device to specify how much medication should be delivered. Later, if your pain symptoms increase your doctor can adjust the dose
  • Flex dosing – The pump can be programmed to vary the amount of medication up to 13 different times throughout a day, so you get more or less drug when you need it. Programming can also vary from day to day to match your scheduled activities
  • Storage of device information – The pump stores important data about your device and settings, so you do not need to carry records if you travel or change clinics. A doctor accesses the information with a clinician programming device
  • Predictable replacement – An alarm will sound before the battery runs out, so you have plenty of time to plan for replacement
  • MRI conditionally safe – The pump allows for full body MRI scans under specific conditions


The myPTM™ personal therapy manager works with the SynchroMed™ II pump and may help alleviate patients’ unpredictable pain (also called breakthrough pain) by delivering a bolus of medication** when needed, within the physician’s programmed parameters:

  • Set a therapeutic daily dose and allow for on-demand bolusing within limits
  • Help customise your treatment with the change in pain level6
Pain control infographic showing 3x faster control

MyPTM™ gives insight for improved therapy management with patient reports. It can help your physician to make informed dosing adjustment using myPTM™ reports.

More patients able to control breakthrough pain x3 faster with myPTM™.5 Time to onset of analgesic effect (or analgesia) dropped from 30 minutes to 10 minutes in patients using myPTM™ vs. conventional breakthrough medications (p <0.001).5

MYPTM™ is easy to use

Smartphone app

Simple visual communication, using friendly design, help you manage your therapy with ease. 

Smartphone image showing timer

The myPTM™ screens feature clear and informative bolus confirmations, lockout details, and alerts. 

Brief Statement

Information contained herein does not replace the recommendations of your healthcare professional. See the device manual for detailed information regarding the instructions for use, indications, contraindications, warnings, precautions, and potential adverse events. For further information, contact your healthcare professional. 

*Every patient experience is unique. Not everyone who receives Medtronic Intrathecal Drug Delivery therapy will experience the same results.
** myPTM™ is approved for use with morphine (not ziconotide), but contraindicated in patients who are opioid naïve.


Smith TJ, Staats PS, Deer T, et al. Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survival. J Clin Oncol. 2002;20:4040-4049. 


Smith TJ, Coyne PJ. Implantable drug delivery systems (IDDS) after failure of comprehensive medical management (CMM) can palliate symptoms in the most refractory cancer pain patients. J Pall Med. 2005;8(4):736-742.


Bhatia G, Lau ME, Koury KM and Gulur P. Intrathecal Drug Delivery (ITDD) systems for cancer pain. F1000Research 2014, 2:96 (doi: 10.12688/f1000research. 2-96.v4)


Corli O, Floriani I, Roberto A, et al. Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV ‘real life’ trial on the variability of response to opioids. Ann Oncol. 2016;27(6):1107–15.


Brogan E, Winter NB, Okifuji A. Prospective Observational Study of Patient-Controlled Intrathecal Analgesia: Impact on Cancer- Associated Symptoms, Breakthrough Pain Control, and Patient Satisfaction. Reg Anesth Pain Med. 2015;40(4):369 -75. 


Ilias W, le Polain B, Buchser E, Demartini L. Patient-controlled analgesia in chronic pain patients: experience with a new device designed to be used with implanted programmable pumps. Pain Pract. 2008;8(3):164-170.