BUTTERBUR Overview Information
Butterbur is an herb. People use the leaf, root, and bulb to make medicine. Some butterbur preparations contain chemicals called pyrrolizidine alkaloids (PAs), which can damage the liver and cause other serious harm. Only butterbur products that are certified and labeled “PA-free” should be used.
Butterbur is used for pain, upset stomach, stomach ulcers, migraine and other headaches, ongoing cough, chills, anxiety, plague, fever, trouble sleeping (insomnia), whooping cough, asthma, hay fever (allergic rhinitis), and for irritable bladder and urinary tract spasms. Butterbur is also used to stimulate the appetite.
Some people apply butterbur to the skin to improve wound healing.
How does it work?
Butterbur contains chemicals that might relieve spasms and decrease swelling (inflammation).
Possibly Effective for:
- Preventing migraine headaches. Taking butterbur by mouth seems to prevent migraine headache. Using a specific extract from the butterbur root over 16 weeks can reduce the number and severity of migraine headaches and the length of time they last. This butterbur extract seems to reduce the number of migraine headaches by almost half. Doses of at least 75 mg twice daily seem to be necessary for best results. Lower doses of 50 mg twice daily may not be effective in adults. There is also some evidence that this butterbur extract can decrease the frequency of migraine headaches in children aged 6-17 years. The butterbur extract researchers used was standardized to 15% petasin and isopetasin (the active ingredients in butterbur) and was free of liver-damaging chemicals called pyrrolizidine alkaloids (PAs). It was made by Petadolex, Weber&Weber, GmbH & Co. of Germany.
- Hay fever caused by grass pollen. Taking a specific butterbur leaf extract seems to decrease nose discomfort in people with hay fever. Some evidence also suggests that this extract might be as effective as 10 mg per day of cetirizine (Zyrtec) or 180 mg per day of fexofenadine (Allegra). The leaf extract used in the research was made by Tesalin, Ze 339, Zeller AG, was free of pyrrolizidine alkaloids (PAs), and was standardized to 8 mg total petasin, an active ingredient.
- Mental illnesses that cause physical pain (somatoform disorders). A study found that taking a product containing butterbur, valerian root, lemon balm leaf, and passionflower reduces anxiety and depression in people with physical pain.
Possibly Ineffective for:
- Skin inflammation (dermatitis). Some research found that taking butterbur extract did not reduce skin inflammation caused by allergies.
- Chronic bronchitis.
- Irritable bladder.
- Urinary tract spasms.
- Other conditions.
BUTTERBUR Side Effects & Safety
Some butterbur products may contain pyrrolizidine alkaloids (PAs), and that’s the major safety concern. PAs can damage the liver, lungs, and blood circulation, and possibly cause cancer. Butterbur products that contain pyrrolizidine alkaloids (PAs) are UNSAFE when taken by mouth or applied to broken skin. Broken skin allows chemicals to be absorbed into the body. Do not use butterbur products unless they are certified and labeled as free of PAs.
PA-free butterbur products are POSSIBLY SAFE for adults and children when taken by mouth appropriately. PA-free root extracts seem to be safe when used for up to 16 weeks in adults. There is some evidence that a specific PA-free butterbur extract (Petadolex, Weber&Weber, GmbH & Co, Germany) can be safely used in children who are 6-17 years old for up to 4 months.
Not enough is known about the safety of using PA-free butterbur products on unbroken skin. Don’t use it.
PA-free butterbur is generally well tolerated. It can cause belching, headache, itchy eyes, diarrhea, asthma, upset stomach, fatigue, and drowsiness. However, it seems to cause less drowsiness and fatigue than cetirizine (Zyrtec). Butterbur products might cause allergic reactions in people who are allergic to ragweed, marigolds, daisies, and other related herbs.
Special Precautions & Warnings:Pregnancy and breast-feeding: Taking butterbur by mouth is LIKELY UNSAFE. Butterbur preparations containing pyrrolizidine alkaloids (PAs) might cause birth defects and liver damage. Not enough is known about the safety of using butterbur products that do not contain PAs during pregnancy or breast-feeding. Don’t use it.
Allergy to ragweed and related plants: Butterbur may cause an allergic reaction in people who are sensitive to the Asteraceae/Compositae family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many others. If you have allergies, be sure to check with your healthcare provider before taking butterbur.
Liver disease: There is some concern that butterbur might make liver disease worse. Don’t take it.
Moderate Interaction Be cautious with this combination
- Medications that increase break down of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers) interacts with BUTTERBUR
Butterbur is broken down by the liver. Some chemicals that form when the liver breaks down butterbur can be harmful. Medications that cause the liver to break down butterbur might enhance the toxic effects of chemicals contained in butterbur.
Some of these medicines include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.
The following doses have been studied in scientific research:
- For preventing migraine headache: a specific butterbur rhizome extract (Petadolex, Weber&Weber, GmbH & Co, Germany) has been used in doses of 50 to 100 mg twice daily with meals. Higher doses seem to be work better. Lower doses of 50 mg twice daily may not be effective in adults. Some researchers suggest taking the extract for 4-6 months, then lowering the dose over time until the number of migraines begins to increase again. That dose would be the recommended one. In 6-9 year-old children with migraine, a dose of 25 mg twice daily has been used; 50 mg twice daily has been used in older children. Three times daily dosing has been used in children who don't respond to the twice daily dose.
- For hay fever (allergic rhinitis): a specific butterbur extract (ZE 339, Zeller AG) one tablet 3-4 times daily has been used. A whole butterbur root extract (Petaforce) in a dose of 50 mg twice daily has also been used for hay fever.