Butterbur

Common Names:

butterbur, petasites, purple butterbur. Butterbur is also known under several patented standardized extract forms, such as Petadolex.

Latin Name:

Petasites hybridus (also known as Petasitidis hybridus, Petasites officinalis, or Tussilago hybrida).

Introduction

This fact sheet provides basic information about the herb butterbur—common names, uses, potential side effects, and resources for more information.
Butterbur is a shrub that grows in Europe and parts of Asia and North America, typically in wet, marshy ground. The name, butterbur, is attributed to the traditional use of its large leaves to wrap butter in warm weather. Butterbur has historically been used for a variety of health issues such as pain, headache, anxiety, cough, fever, and gastrointestinal and urinary tract conditions. It has also been used topically to improve wound healing. Today, traditional or folk uses include nasal allergies, allergic skin reactions, asthma, and migraine headache.
The leaves, rhizomes (underground stems), and roots of butterbur are commonly used to make solid extracts used in tablets. Some butterbur extracts are also used topically.

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What the Science Says

An NCCAM-funded literature review reports that in a clinical trial of 125 participants, butterbur was just as effective as a commonly used oral antihistamine for allergy symptoms such as itchy eyes.
According to one systematic literature review, there is evidence to support the effectiveness of butterbur for the treatment of migraines.
There is some evidence that butterbur extract can decrease the symptoms associated with nasal allergies.
There is not enough evidence to show efficacy and safety of butterbur for allergic skin reactions and asthma.

Side Effects and Cautions

The raw, unprocessed butterbur plant contains chemicals called pyrrolizidine alkaloids (PAs). PAs can cause liver damage and can result in serious illness. Only butterbur products that have been processed to remove PAs and are labeled or certified as PA-free should be used.
Several studies, including a few studies of children and adolescents, have reported that PA-free butterbur products are safe and well tolerated when taken by mouth in recommended doses for up to 12 to 16 weeks. The safety of longer-term use has not been established.
Butterbur can cause belching, headache, itchy eyes, gastrointestinal issues, asthma, fatigue, and drowsiness.
Butterbur may cause allergic reactions in people who are sensitive to plants such as ragweed, chrysanthemums, marigolds, and daisies.
Butterbur should only be given to children under the supervision of a qualified health practitioner.
Tell all your health care providers about any complementary approaches you use, including herbs. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary and alternative medicine, see NCCAM’s Time to Talk campaign.

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Sources

Agosti R, Duke RK, Chrubasik JE, et al. Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: a systematic review. Phytomedicine. 2006;13(9–10):743–746.
Bielory L, Heimall J. Review of complementary and alternative medicine in treatment of ocular allergies. Current Opinion in Allergy and Clinical Immunology. 2003;3(5):395–399.
Butterbur. Natural Medicines Comprehensive Database Web site. Accessed at www.naturaldatabase.com on April 29, 2011.
Butterbur (Petasites hybridus). Natural Standard Database Web site. Accessed at www.naturalstandard.com on April 29, 2011.
Schapowal A. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002;324(7330):144–146.

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For More Information

National Center for Complementary and Alternative Medicine. Using Dietary Supplements Wisely.

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NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.