Butterbur (Petasites)

Butterbur is a shrub that is found throughout Europe as well as mild parts of Asia. It also now grows in parts of the US. The name "butterbur" developed because the large leaves of the shrub are used to wrap butter during warm weather.

People take butterbur by mouth for pain, upset stomach, stomach ulcers, migraine and other headaches, ongoing cough, chills, anxiety, plague, fever, trouble sleeping (insomnia), whooping cough, asthma, a lung disease called chronic obstructive bronchitis, hay fever (allergic rhinitis), eczema, mental illnesses that cause symptoms in the body (somatoform disorders), and for irritable bladder and urinary tract spasms. Butterbur is also taken by mouth 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).

Hay fever caused by grass pollen.
Migraine headaches.
Mental illnesses that cause physical pain (somatoform disorders).
Asthma.
Chronic obstructive bronchitis.

Adult

By Mouth:

For hay fever (allergic rhinitis): Up to 6 tablets of a specific butterbur leaf extract called Ze 339 (Tesalin, Zeller AG), has been taken daily in up to three divided doses for 1-2 weeks. 50 mg of a specific whole butterbur root extract (Petaforce, Bioforce) has been taken twice daily for 2 weeks.

For migraine headache: 75-150 mg of a specific butterbur rhizome extract (Petadolex, Weber & Weber, GmbH & Co, Germany) has been taken daily in up to two divided doses for up to 4 months.

For mental illnesses that cause physical pain (somatoform disorders): A specific product called Ze185 (Relaxane, Max Zeller Söhne AG, Switzerland) containing 90 mg of dry extracts of butterbur root, 90 mg of valerian root, 90 mg of passionflower herb, and 60 mg of lemon balm leaf, has been taken three times daily for 2 weeks.

Children

By Mouth:

For migraine headache: 50-75 mg of a specific butterbur rhizome extract (Petadolex, Weber & Weber, GmbH & Co, Germany) has been taken daily in two or three divided doses for children 8-9 years-old, and in doses of 100-150 mg daily in two or three divided doses for children 10-17 years-old, for up to 4 months.

Pyrrolizidine alkaloid (PA)-free butterbur products are SAFE when taken by mouth appropriately for up to 16 weeks. Some butterbur products may contain 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 PAs are LIKELY 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.

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.

Children: Pyrrolizidine alkaloid (PA)-free butterbur is SAFE when taken by mouth appropriately. There is some evidence that a specific PA-free butterbur rhizome extract (Petadolex, Weber & Weber, GmbH & Co, Germany) can be safely used in children aged 6-17 years for up to 4 months.

Pregnancy and breast-feeding: Taking butterbur by mouth is LIKELY UNSAFE while pregnant or breast-feeding. 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.