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This fact sheet provides basic information about butterbur—common names, what the science says, potential side effects and cautions, 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.
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 health approaches you use. 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.
For More Information
The NCCAM Clearinghouse provides information on NCCAM and complementary health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
A service of the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals.
Office of Dietary Supplements (ODS), National Institutes of Health (NIH)
ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public. Its resources include publications (such as Dietary Supplements: What You Need to Know), fact sheets on a variety of specific supplement ingredients and products (such as vitamin D and multivitamin/mineral supplements), and the PubMed Dietary Supplement Subset.
PubMed Dietary Supplement Subset: ods.od.nih.gov/Research/PubMed_Dietary_Supplement_Subset.aspx
- 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.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.