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Butterbur (generic name)

treats Allergic rhinitis prevention, Migraine prophylaxis, Allergic skin disease, and Asthma
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Interactions with Drugs

Administration of butterbur with anticholinergics may not be advisable. Numerous drugs and drug classes may interact with anticholinergic agents. Examples include: acetophenenazine, amantadine, amitriptyline, atropine, benztropine, bethanechol, biperiden, brompheniramine, carbinoxamine, chlorpromazine, clemastine, clindinium, clozapine, cyclopentolate, cyproheptadine, dicyclomine, diphenhydramine, dixyrazine, ethopropazine, fenotherol, fluphenazine, haloperidol, homatropine, hyosciamine, ipratropium, loxapine, mesoridazine, methdilazine, methotrimeprazine, olanzapine, oxybutynin, perazine, periciazine, perphenazine, pimozide, pipotiazine, prochlorperazine, procyclidine, promazine, promethazine, propiomazine, quinidine, scopolamine, thiethylperazine, thioridazine, thiothixene, trifluoperazine, triflupromazine, trihexyphenidyl, trimeprazine, triprolidine. Consult with a qualified healthcare professional, including a pharmacist, before taking butterbur preparations.

Interactions with Herbs and Dietary Supplements

Raw, unprocessed butterbur may contain toxic pyrrolizidine alkaloids, although commercially available products should be free of pyrrolizidine alkaloids. Nonetheless, concomitant use of other agents containing pyrrolizidine alkaloids should be avoided due to the potential for additive toxicity.

Combination use with anticholinergic agents may potentiate therapeutic and adverse effects. Examples of anticholinergic herbs include belladonna, bittersweet (Solanum dulcamara), henbane (Hyoscyamus niger), and Jimson weed (Datura stramonium).


This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration ( Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Mary Giles, PharmD (University of Rhode Island); Christine Park, PharmD (Northeastern University); Karta Purkh Singh Khalsa, CDN, RH (Bastyr University); Catherine DeFranco Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).


DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to Selected references are listed below.

Brattstrom A. A newly developed extract (Ze 339) from butterbur (Petasites hybridus L.) is clinically efficient in allergic rhinitis (hay fever). Phytomedicine 2003;10 Suppl 4:50-52.

Danesch U, Rittinghausen R. Safety of a patented special butterbur root extract for migraine prevention. Headache 2003;43(1):76-78.

Danesch UC. Petasites hybridus (Butterbur root) extract in the treatment of asthma--an open trial. Altern Med Rev 2004;9(1):54-62.

Diener HC, Rahlfs VW, Danesch U. The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: reanalysis of efficacy criteria. Eur Neurol 2004;51(2):89-97.

Fiebich BL, Grozdeva M, Hess S, et al. Petasites hybridus extracts in vitro inhibit COX-2 and PGE2 release by direct interaction with the enzyme and by preventing p42/44 MAP kinase activation in rat primary microglial cells. Planta Med 2005;71(1):12-19.

Gray RD, Haggart K, Lee DK, et al. Effects of butterbur treatment in intermittent allergic rhinitis: a placebo-controlled evaluation. Ann Allergy Asthma Immunol 2004;93(1):56-60.

Grossman W, Schmidramsl H. An extract of Petasites hybridus is effective in the prophylaxis of migraine. Altern Med Rev 2001;6(3):303-310.

Grossmann M, Schmidramsl H. An extract of Petasites hybridus is effective in the prophylaxis of migraine. Int J Clin Pharmacol Ther 2000;38(9):430-435.

Jackson CM, Lee DK, Lipworth BJ. The effects of butterbur on the histamine and allergen cutaneous response. Ann Allergy Asthma Immunol 2004;92(2):250-254.

Lee DK, Carstairs IJ, Haggart K, et al. Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis. Clin Exp Allergy 2003;33(7):882-886.

Lee DK, Gray RD, Robb FM, et al. A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Clin Exp Allergy 2004;34(4):646-649.

Lee DK, Haggart K, Robb FM, et al. Butterbur, a herbal remedy, confers complementary anti-inflammatory activity in asthmatic patients receiving inhaled corticosteroids. Clin Exp Allergy 2004;34(1):110-114.

Lipton RB, Gobel H, Einhaupl KM, et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology 2004;63(12):2240-2244.

Schapowal A. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ 2002;324(7330):144-146.

Thomet OA, Schapowal A, Heinisch IV, et al. Anti-inflammatory activity of an extract of Petasites hybridus in allergic rhinitis. Int Immunopharmacol 2002;2(7):997-1006.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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