Burten

Quick links to important sections

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Burten

Property Description
Active ingredient Ketorolac tromethamine
Form Tablet, Injectable solution, Ophthalmic solution, Nasal spray
Pharmacological class Nonsteroidal Anti-inflammatory Drug (NSAID)
Common use Management of moderate to severe acute pain
Origin Synthetic organic compound

Burten: Definition and Potent Analgesic Classification

Burten is the trade name for a potent medicine whose active ingredient is Ketorolac tromethamine. It is formally classified as a Nonsteroidal Anti-inflammatory Drug (NSAID), belonging to the pyrolo-pyrrole group. This substance is a synthetic organic compound designed primarily for powerful pain management, and it is explicitly a non-narcotic analgesic, meaning it lacks the potential for physical dependency associated with opioid drugs. The efficacy of Ketorolac is clinically recognized for providing a high level of pain relief comparable to that achieved by certain opioid analgesics. Its therapeutic purpose is the short-term management of moderate to severe acute pain, such as the discomfort often experienced immediately following a surgical procedure.


Composition and Available Pharmaceutical Forms

The medicine is a single-ingredient product where the active substance, Ketorolac tromethamine, is a racemic mixture containing both the active S-enantiomer and the less active R-enantiomer. This therapeutic agent is prepared in several dosage forms to accommodate various medical needs. These preparations include tablets for oral administration, an injectable solution for parenteral routes (intramuscular and intravenous), and specialized solutions for nasal and ophthalmic (eye) application, allowing for targeted or systemic delivery of the compound. The various formulations, particularly the injectable solution, are utilized for the swift management of acute pain.


Ketorolac's Therapeutic Role as an Opioid-Sparing Agent

Burten's function is to interrupt the body's natural chemical processes that cause pain and inflammation, providing a strong analgesic effect. This high potency allows it to serve as a valuable opioid-sparing agent, which is a key distinguishing factor in pain treatment protocols. Its primary benefit is providing effective, rapid reduction of discomfort related to acute injuries or procedures.

Regulatory References

  1. Ketorolac - StatPearls - NCBI Bookshelf
  2. Omidria | European Medicines Agency (EMA) EPAR Summary

What side effects are possible with Burten?

Possible side effects and safety information

Ketorolac tromethamine, the active ingredient in Burten, is an NSAID with a safety profile rigorously defined by authoritative regulatory documents. The profile includes mandatory warnings regarding serious systemic risks and strictly limits the duration of use for systemic formulations.

Serious Adverse Reactions

Official labeling emphasizes the potential for serious, sometimes fatal, outcomes affecting major organ systems:

  • Gastrointestinal Risk: This includes the possibility of peptic ulcers, bleeding, and perforation of the stomach or intestines, which may occur at any time during use and without warning symptoms.
  • Cardiovascular Risk: The medication is associated with an increased risk of serious cardiovascular thrombotic events, such as myocardial infarction (heart attack) and stroke.
  • Renal Risk: Reactions include the potential for acute renal failure and injury to the kidneys.

Commonly Documented Adverse Reactions

Adverse reactions that are frequently listed in regulatory documents (occurring in 1% to 10% of patients) span several system-organ classes, including the Nervous System (headache, dizziness, drowsiness), the Gastrointestinal System (nausea, dyspepsia, diarrhoea), and general reactions (edema, hypertension) [FDA DailyMed]. Nausea and headache have been reported with an incidence greater than 10%.

Duration and Population Safety Constraints

The total combined duration of systemic use (e.g., tablets and injection) must not exceed five days in adults, as the risk of serious adverse events increases with longer exposure. The drug is CONTRAINDICATED in specific high-risk populations, including those with advanced renal impairment, active peptic ulcer disease, or a history of recent gastrointestinal bleeding. Elderly patients (aged 65 years and older) are at a greater risk for serious gastrointestinal events and require careful consideration.

Overdose and Emergency Response

Overdose and when to seek help

Overdose with Burten, whose active substance is Ketorolac tromethamine, requires immediate, formal intervention. Symptoms following an acute overdose are typically limited to nausea, vomiting, epigastric pain, lethargy, and drowsiness, which are generally reversible with supportive care, according to regulatory labeling. Specific single overdoses have also been associated with abdominal pain, hyperventilation, and signs of renal dysfunction.

Severe Outcomes and Emergency Actions

The regulatory profile lists potential severe outcomes, emphasizing the risk of gastrointestinal bleeding, peptic ulcers, and erosive gastritis. Rare, but documented, severe effects include acute renal failure, hypertension, respiratory depression, and coma.

Immediate medical attention must be sought for any suspected overdose. Emergency services (e.g., 911) must be contacted immediately if the affected person has collapsed, experienced a seizure, has trouble breathing, or cannot be awakened. The poison control helpline should be called for specific guidance.

Procedural Management

The official documents confirm that no specific antidotes are known for Burten overdose. Management is based entirely on providing symptomatic and supportive care. For large oral overdoses (5 to 10 times the usual dose) seen within four hours or if the patient is symptomatic, procedures may include administering activated charcoal and/or an osmotic cathartic.

Therapeutic Uses of Burten

What Burten Treats: Main Uses and Benefits

Burten is a medication focused on providing supportive symptomatic relief across various therapeutic domains marked by heightened discomfort and challenging manifestations. The primary role of Burten is to ease the overall symptom load, which is applicable across therapeutic domains where supportive management is appropriate. This approach aligns with clinical standards for developing treatments for acute symptom management. It is applied across domains where additional symptomatic support is needed, supporting general well-being during difficult episodes of temporary physiological imbalance.

The medication is commonly used across conditions presenting with acute episodes and relevant in situations involving recurrent or episodic manifestations. It is used for managing symptom clusters that may become intense or disruptive, and is applied when symptoms create noticeable functional strain.

Supportive Use Scenarios

Burten is relevant for managing symptoms that interfere with daily comfort, and may assist with maintaining functional stability during difficult episodes. This is relevant in contexts marked by increased discomfort or tension, and often used when symptoms intensify and supportive relief is needed. It supports the patient during these phases, and may help patients cope more steadily with symptom fluctuations.


Quick Fact: Focuses on Symptom Fluctuations

Eligibility and Restrictions for Use

Official Eligibility and Contraindications

Burten (Ketorolac tromethamine) is a potent Nonsteroidal Anti-inflammatory Drug (NSAID) whose use is strictly governed by regulatory labeling. It is indicated for adult patients (17 years of age and older) for the short-term management of moderately severe acute pain, with total treatment duration not exceeding five days.

Absolute Contraindications

Use of Burten is strictly prohibited in several patient populations, as defined by regulatory authorities:

  • Patients with active peptic ulcer disease or a history of GI bleeding/perforation.
  • Patients with advanced renal impairment or those at risk for renal failure due to volume depletion.
  • Individuals with confirmed hypersensitivity to aspirin or other NSAIDs (including aspirin-sensitive asthma).
  • Patients at high risk of bleeding (e.g., suspected cerebrovascular bleeding) or those currently receiving aspirin or other NSAIDs.
  • In the setting of peri-operative CABG surgery.

Restricted and Non-Eligible Groups

The medicine is contraindicated during labor and delivery and is not recommended for breastfeeding women. The safety and efficacy have not been established in pediatric patients (under 17 years). Older adult patients (65 years and over) or those weighing less than 50 kg require conditional use with special regulatory considerations.

What should I know about interactions with other medicines?

The interaction profile for Burten is defined by regulatory constraints that establish mandatory limitations on co-administration with other substances. Several combinations are formal contraindications. Co-administration with other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) or Aspirin is prohibited due to the cumulative risk of serious gastrointestinal adverse events. Probenecid is also contraindicated because it causes a significant pharmacokinetic interaction leading to a three-fold increase in Ketorolac plasma exposure and reduced clearance. The co-use of Pentoxifylline is similarly prohibited due to an officially documented heightened risk of bleeding.

Specific drug classes are associated with pharmacodynamic risk reinforcement. Using Burten with Anticoagulants (such as Warfarin) carries a synergistic risk of hemorrhage. Furthermore, Burten can reduce the natriuretic efficacy of Diuretics and may diminish the antihypertensive effect of ACE Inhibitors or ARBs. Exposure-altering interactions are documented with Lithium, which experiences elevated plasma levels due to reduced renal clearance, and with Salicylates, which increase the unbound fraction of Ketorolac. Concomitant ingestion of alcohol is officially documented to increase the risk of GI bleeding. Procedurally, the injectable formulation must not be mixed with certain substances, including morphine sulfate, due to documented physical incompatibility. In elderly patients, slower clearance may increase the severity of these interactions.

Mechanism of Action

Modulation of the Prostaglandin Synthesis Pathway

Burten's mechanism is centered on the significant, non-selective inhibition of the Cyclooxygenase (COX) enzyme, blocking both the COX-1 and COX-2 isoenzymes. This molecular action interrupts the conversion of the fatty acid precursor arachidonic acid into prostaglandins, which are critical mediators in physiological signaling.

Dampening Nociceptive Signal Transmission

The drastic reduction in prostaglandins, particularly PGE2, produces a dual physiological effect: it de-sensitizes peripheral nociceptors (pain-sensing nerves) at the site of tissue injury and concurrently modulates signal amplification within the spinal cord. This combined peripheral and central mechanism produces significant suppression of the nociceptive signaling pathway, resulting in a functional alteration of the physiological state.

Constraint of Non-Selective Enzyme Inhibition

The mechanism's non-selective nature, involving the inhibition of the constitutive COX-1 enzyme alongside the inducible COX-2 enzyme, constrains the scope of its application. This action engages systems that regulate essential homeostatic functions, which limits the operational scope of the mechanism.

Dosage and Administration Information

Instruction Map: How to use Burten — Administration Guidelines

Burten, whose active ingredient is Ketorolac tromethamine, is administered via Intravenous (IV) injection, Intramuscular (IM) injection, and Oral tablet. Instructions strictly define its use as a short-term, sequential course of therapy that must not exceed a total duration of five days for combined systemic use.


Administration Scope

Entity Detail
Dosing schedule Standard Adult Dose (IV/IM): 30 mg every 6 hours. Max Daily Dose (Standard): 120 mg (parenteral) or 40 mg (oral).
Timing in relation to meals Oral tablets may be taken with food, although this may delay the time to achieve peak concentration.
Age-group administration rules The maximum total daily dose must not exceed 60 mg for older adults (65 years), patients with low body weight, or those with renal impairment.

Resulting Procedural Structure

Instructions establish a strict protocol for use:

  • Initiation: Treatment typically begins via the parenteral route (IV or IM injection). The IV dose must be administered over no less than 15 seconds.
  • Transition: Following initial control, the 10 mg oral tablet is used for maintenance, as it is strictly indicated for continuation treatment and not for therapy initiation.
  • Procedural Condition: The injectable solution must not be mixed with certain other analgesic solutions due to chemical incompatibility.

Connection to the overall use protocol

This protocol structures Burten as a defined, limited-duration course where parenteral use is transitioned to oral use to complete the short-term analgesic requirement. The specific dose ceilings and frequency requirements ensure adherence to the established constraints on systemic NSAID usage.

Recent Clinical Evidence

Research evidence / Overview of Studies for Burten

Evidence for Use in Acute Pain Management (Systemic)

Research related to Burten (Ketorolac tromethamine) in the systemic management of acute pain includes numerous randomized controlled trials (RCTs) and subsequent systematic reviews and meta-analyses. These studies were conducted to explore how symptoms change over time in adult patients experiencing severe short-term discomfort, such as pain immediately following a surgical procedure or an acute trauma. These trials were evaluated in research exploring how symptoms change over time by comparing Burten against an inactive substance (placebo) or other standard comparator medications.

The research examined several outcomes reflecting acute changes, including shifts in pain intensity scores and the total amount of additional pain medication (often opioids) patients needed during the defined study interval. Studies examined whether the use of Burten was associated with measured changes in acute pain intensity, and research described patterns related to the overall consumption of opioids recorded by patients in the short post-operative period. Research describes that these measured changes were observed across different administration routes, including injectable and oral forms.


Evidence in Pediatric and Other Special Populations

Research has also examined the use of the injectable formulation in certain special populations, particularly children and adolescents (typically aged 6 to 17 years) presenting with episodes of heightened symptoms, such as acute pain in the emergency department. These studies, which include a combination of systematic reviews and randomized trials, were conducted during periods of increased symptom activity to evaluate pain intensity scores and the need for rescue analgesia in this younger group.

Specific research focusing on older adults has described pharmacokinetic patterns that differ from those observed in younger adult subjects. These findings indicate that the medicine may remain in the body for a longer time in older adults, and the results apply only to the specific populations studied.


Areas of Research Uncertainty and Gaps

A key characteristic of the Burten research landscape is the strict focus on short-term study durations, typically five days or less. This short follow-up duration is consistent with the intended therapeutic scope; the initial evidence base did not include data evaluating the medicine beyond this time frame. The research reflects the constraints of the evidence, which restrict the total combined duration of use for the injectable and oral forms to not exceed five days. The most significant gap remains the absence of any long-term research that extends beyond the acute five-day treatment period.

Key Studies & References

  1. Topical Nonsteroidal Anti-inflammatory Drugs in the Management of Postoperative Ocular Inflammation and Pain: A Systematic Review

Frequently Asked Questions (FAQ)

Common questions about Burten (FAQ)


Q: What is the main reason doctors prescribe Burten?

Official regulatory documents state that Burten is indicated for the short-term management of moderately severe acute pain. Official information indicates the drug is used for pain that requires a high level of analgesia, often compared to the pain relief provided by opioid medications.


Q: Is Burten the same type of drug as [Name of common similar drug]?

Regulatory documents classify Burten as a Non-Steroidal Anti-inflammatory Drug (NSAID). Its action centers on non-selective inhibition of the Cyclooxygenase (COX) enzyme pathway, which describes the general type of medication it is.


Q: Does Burten have a generic version available?

Yes, the active ingredient in Burten, Ketorolac tromethamine, is officially available in generic form. Generic medications are required to demonstrate bioequivalence, meaning they are expected to work in the same way as the brand-name product.


Q: How quickly does Burten start working after taking it?

Official product information indicates that the analgesic effect typically begins approximately 30 minutes after intravenous (IV) or intramuscular (IM) administration. The maximum effect is generally achieved within one to two hours following administration.


Q: How long does the effect of one dose of Burten last?

Studies and official information indicate that the median duration of the pain-relieving effect from a single dose is generally reported to be between four and six hours.


Q: Is Burten considered a controlled substance?

No, official scheduling documents from regulatory bodies confirm that Burten is not listed as a controlled substance under the DEA schedule.


Q: Can Burten cause weight gain or weight loss?

Regulatory documents list 'weight change' and 'unusual weight gain' as adverse reactions that have been reported by some patients.


Q: Are there any serious side effects linked to Burten?

Yes, official drug labels contain a Boxed Warning highlighting several serious risks. These include gastrointestinal ulceration, bleeding, and perforation, as well as an increased risk of serious cardiovascular thrombotic events like heart attack and stroke.


Q: What are the most common side effects that people report for Burten?

Based on clinical trials, the most frequently reported adverse experiences include headaches, nausea, abdominal pain, drowsiness, and dizziness. These are generally reported in 1% to over 10% of patients who use the medication.


Q: Does Burten affect sleep?

Official adverse reaction reports include various sleep-related issues. These include drowsiness, somnolence (sleepiness), and insomnia (difficulty falling or staying asleep).


Q: Is it normal to feel dizzy when starting Burten?

Dizziness is officially listed as a commonly reported adverse experience. It has been reported by 1% to 10% of patients in clinical settings.


Q: Can taking Burten make me feel tired or drowsy?

Official documents list both drowsiness and asthenia (unusual tiredness or weakness) as reported side effects. These reactions can potentially affect a person's level of alertness.


Q: Is Burten approved for children?

Regulatory information states that the safety and efficacy of the drug have not been definitively established in children. Therefore, use is generally not recommended in pediatric patients, specifically those under 16 years of age.


Q: What information is available about using Burten during pregnancy?

The use of this drug is contraindicated (strongly advised against) during the third trimester of pregnancy (starting at 30 weeks gestation). This is due to the potential risk of premature closure of the fetal ductus arteriosus and fetal renal dysfunction.


Q: Can Burten be used while breastfeeding?

According to official product information, the drug is contraindicated during lactation. Studies have shown that the active ingredient is excreted in human breast milk.


Q: Is there a risk of dependence with Burten?

As the drug is an NSAID and is not classified as a controlled substance by the DEA, official information does not indicate a risk of physical dependence typically associated with opioid medications.


Q: How is Burten different from a placebo in clinical trials?

The drug works by inhibiting the COX enzyme pathway, which produces verifiable analgesic and anti-inflammatory effects. These effects have been shown to be effective in providing pain relief when compared to the effects seen with a placebo in clinical settings.


Q: Are there any dietary restrictions while taking Burten?

Official interaction documents explicitly warn against the co-ingestion of alcohol while taking this medication. This combination is officially documented to increase the risk of serious gastrointestinal bleeding.


Q: How is Burten described in official FDA documents?

The FDA describes the drug as a member of the pyrrolo-pyrrole group of Non-Steroidal Anti-inflammatory Drugs (NSAIDs). It is indicated for the short-term, limited duration management of moderately severe acute pain.


Q: Why do some patient communities mention headaches as a side effect?

Headache is listed in official adverse reaction data as one of the most frequently reported side effects. Clinical trial data shows it occurs in more than 10% of patients.


Q: Does Burten affect blood pressure?

Official documents list hypertension (high blood pressure) as a reported adverse reaction in clinical trials. The drug should also be used with caution in patients with pre-existing high blood pressure.


Q: Can Burten affect the results of a laboratory test?

Yes, official adverse reaction reports include results that can affect laboratory testing. These include changes such as increased bleeding time, as well as elevations in liver enzymes.


Q: Is Burten intended to be a cure for the condition it treats?

No, official documents indicate that the drug is intended solely for the short-term management of pain. It works by managing symptoms and is not described as a cure for the underlying condition.


Q: What are the conditions where Burten is generally not recommended?

Official product information lists specific conditions that contraindicate use, including active peptic ulcer disease, recent gastrointestinal bleeding or perforation, severe heart failure, and advanced renal impairment. These conditions are explicitly listed as contraindications in official regulatory documents.


Q: Is it required to have a prescription to get Burten?

Yes, the drug is officially classified as a Human Prescription Drug (Rx only). This means a prescription from a licensed healthcare provider is required to obtain the medication.


Q: Do studies suggest Burten is more effective for some patient groups than others?

Official dosing instructions mandate lower maximum daily doses for older adults, patients with low body weight, and those with renal impairment. This indicates a differential safety and risk profile in these specific patient groups.


Q: What is the half-life of Burten, as described in official documents?

According to official clinical pharmacology data, the half-life for the racemic mixture of the drug (the time it takes for half the drug to be eliminated from the body) is reported to be in the range of five to six hours.


Q: How does the use of Burten relate to driving or operating machinery?

Because side effects like dizziness and drowsiness are reported, official regulatory warnings caution about performing hazardous tasks, such as driving or operating machinery.


Q: Are there studies on Burten use in patients with liver impairment?

Yes, studies have examined the drug's pharmacokinetics in patients with liver disease. These studies reported no significant differences in plasma exposure or half-life when compared to healthy volunteers.


Q: What is the storage advice for Burten?

Official labeling advises that the tablets should be stored at controlled room temperature. This is typically between 20^circ to 25^circ ext C (68^circ to 77^circ ext F).


Q: Is Burten known to cause allergic reactions?

Yes, official adverse event reports list both hypersensitivity reactions and serious anaphylactic/anaphylactoid reactions. The drug is also strictly contraindicated in patients with a known history of allergy to NSAIDs or Aspirin.


Q: How long after stopping Burten does the substance clear the body?

Regulatory documents indicate that the drug is primarily eliminated via the kidneys (renal excretion), with approximately 92% of a dose being recovered in the urine. The drug's half-life provides a measure of the clearance process.


Q: Does taking Burten require regular blood monitoring?

Official warnings discuss risks associated with the drug, including risks to renal and liver function and increased bleeding time. These factors are listed as risks that may necessitate medical oversight.


Q: Do different brands of Burten work exactly the same way?

Regulatory processes require that any generic versions of the drug must be demonstrated to be bioequivalent to the brand-name product. This means that they are expected to be therapeutically equivalent and work in the same way.


Q: Is Burten effective for the mildest forms of the condition it treats?

The drug is specifically indicated in official documents for the management of moderately severe acute pain. This suggests it is not typically intended for the symptomatic relief of mild pain.


Q: What does the patient information leaflet say about drug overdose?

Official overdose information lists symptoms such as lethargy, drowsiness, nausea, vomiting, and epigastric pain. These symptoms are generally reversible, and treatment for an overdose is typically supportive.


Q: Why is Burten sometimes described as an adjunctive treatment?

The drug is used for pain management that requires analgesia at the opioid level. It is often utilized in a short-term, sequential course to help manage acute, severe pain, sometimes alongside or in place of opioid medications.


Q: Does Burten have any Black Box Warnings listed by the FDA?

Yes, the drug label contains an official Boxed Warning. This warning highlights the significant, potentially serious risks associated with cardiovascular thrombotic events, gastrointestinal toxicity, and bleeding.

How should Burten be stored and disposed of?

This information is based on official regulatory labeling for buprenorphine transdermal systems, a controlled substance often referenced by similar names.

Storage Requirements

Requirement Regulatory Statement
Temperature Store at controlled room temperature, 20 C to 25 C (68 F to 77 F).
Handling Keep in the original sealed pouch until time of use; do not cut or damage the patch.
Protection Do not refrigerate or freeze. Store securely out of the sight and reach of children.

Disposal Instructions

Due to the presence of residual medicine and the potential for severe harm or misuse, official regulatory documents require specific disposal methods immediately upon removal:

  1. Fold the used patch so the sticky adhesive side sticks to itself.
  2. Dispose of the folded patch by flushing it down the toilet right away, or by placing it in a co-packaged disposal unit.
  3. Unused or expired patches should be disposed of in the same manner to prevent accidental exposure or diversion.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Burten found in:

A-Z Index: