Butterbur (generic name)

treats Allergic rhinitis prevention, Migraine prophylaxis, Allergic skin disease, and Asthma
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Average Ratings

Dosing

Adults (18 years and older)

Studies have reported safety and good tolerability of commercially available butterbur products (which are free of potentially carcinogenic pyrrolizidine alkaloid constituents), when used orally in recommended doses for up to 12-16 weeks.

For allergic rhinitis, 50 milligrams of standardized butterbur (Petadolex®, standardized to contain 7.5 milligrams of petasin and isopetasin per 50-milligrams tablet) has been used twice daily. A large study used one tablet of carbon dioxide extract standardized to 8.0 milligrams of total petasin per tablet (Tesalin®), taken four times daily, while a smaller study reported that 2 standardized tablets taken three times daily was effective.

Dosing for asthma is undefined due to a lack of evidence. However, 50 milligrams of standardized butterbur (Petaforce®), administered in two divided daily doses, in patients maintained on inhaled corticosteroids has been used. Petadolex® 150 milligrams daily in three divided daily doses for 2-4 months has also been studied.

For migraine prophylaxis, 50-75 milligrams Petadolex® twice daily for up to four months has been studied. One study suggested that the 75-milligram dose but not the 50-milligram dose is effective.

Children (younger than 18 years)

For asthma, 50-150 milligrams daily (depending on age) of a pyrrolizidine-free butterbur rhizome extract standardized to 7.5 milligrams of petasin and isopetasin per 50-milligram tablet (Petadolex®) may be effective. However, due to a lack of safety and efficacy data, butterbur cannot be recommended for this or any other use in children at this time.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to Petasites hybridus or other plants from the Asteraceae/Compositae family such as ragweed, marigolds, daisies, and chrysanthemums.

Side Effects and Warnings

Studies have reported safety and good tolerability of commercially available butterbur products (which are free of potentially carcinogenic pyrrolizidine alkaloid constituents), when used orally in recommended doses short-term. Raw, unprocessed butterbur plant should not be ingested due to the potential hepatotoxicity (liver damaging) of pyrrolizidine alkaloids with long-term use (specifically, concern of veno-occlusive disease). This includes any teas, capsules of raw herb, or unprocessed tinctures or extracts. Use should be limited to commercially available products that are free of pyrrolizidine alkaloids. The plant's pyrrolizidine alkaloids are also thought to be carcinogenic (cancer causing), mutagenic, and nephrotoxic (kidney damaging).

When taken by mouth, butterbur may cause headache, drowsiness, fatigue, itchy eyes, eye discoloration, breathing difficulties, skin discoloration or pruritis (severe itching).

Butterbur taken by mouth may also cause sustained constipation, discoloration of stool, dysphagia (difficulty swallowing), severe nausea, vomiting, diarrhea, or stomach upset. Butterbur may increase liver enzyme levels.

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Pregnancy and Breastfeeding

Butterbur (Petasites hybridus) is not recommended in women who are pregnant or breastfeeding due to a lack of safety studies.

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