BUTTERBUR

OTHER NAME(S):

Blatterdock, Bog Rhubarb, Bogshorns, Butter Bur, Butterburr, Butter-Dock, Butterfly Dock, Capdockin, Chapelière, Contre-Peste, Exwort, Flapperdock, Feuille de Pétasite, Fleur de Pétasite, Grand Bonnet, Herbe à la Peste, Herbe aux Teigneux, Japanese Butterbur, Japonica Petasites, Langwort, Pestwurz, Pétasite, Pétasite du Japon, Pétasite Hybride, Pétasite Japonaise, Pétasite Officinal, Pétasite Vulgaire, Petasites, Petasites hybridus, Petasites officinalis, Petasitidis Folium, Petasitidis Rhizoma, Petasitidis hybridus, Petasites Japonicus, Petasites Vulgaris, Plague Root, Purple Butterbur, Racine de Pétasite, Rhizome de Pétasite, Tussilago hybrida, Umbrella Leaves.

Overview

Overview Information

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.

Butterbur is used for migraine, hay fever (allergic rhinitis), and emotional distress caused by extreme focus on a physical symptom (somatic symptom disorder). It is also used for lung and gastrointestinal conditions and irritable bladder, but there is no strong evidence to support these uses.

How does it work?

Butterbur contains chemicals that might relieve spasms and decrease swelling (inflammation).

Uses

Uses & Effectiveness?

Possibly Effective for

  • Hay fever. Taking a specific butterbur leaf extract called Ze 339 (Tesalin, Zeller AG) seems to decrease nose discomfort in people with hay fever. Some research also shows that this extract might be as effective as 10 mg daily of cetirizine (Zyrtec) or 180 mg daily of fexofenadine (Allegra). But this extract does not seem to improve airflow, nasal and eye symptoms, or quality of life when taken for 2 weeks.
  • Migraine. Taking butterbur by mouth seems to prevent migraine headache. Using a specific extract from the butterbur root (Petadolex, Weber & Weber, GmbH & Co) over 16 weeks can reduce the number and severity of migraine headaches and the length of time they last. This butterbur extract seems to reduce the number of migraine headaches by almost half. Doses of at least 75 mg twice daily seem to be necessary for best results. Lower doses of 50 mg twice daily may not be effective in adults. There is also some evidence that this butterbur extract can decrease the frequency of migraine headaches in children aged 6-17 years.
  • Emotional distress caused by extreme focus on a physical symptom (somatic symptom disorder). Research shows that taking a product called Ze185 that contains butterbur, valerian root, lemon balm leaf, and passionflower (Relaxane, Max Zeller Söhne AG) reduces anxiety and depression in people with physical pain.

Possibly Ineffective for

  • Eczema (atopic dermatitis). Some research shows that taking butterbur extract twice daily for one week does not reduce symptoms of eczema.

Insufficient Evidence for

  • Asthma. Early research suggests that butterbur might help reduce the number of asthma attacks in some adults or teenagers with asthma.
  • Anxiety.
  • Chills.
  • Colic.
  • Cough.
  • Fever.
  • Insomnia.
  • Irritable bladder.
  • Long-term swelling (inflammation) of the airways in the lungs (chronic bronchitis).
  • Pain.
  • Plague.
  • Stomach ulcers.
  • Upset stomach.
  • Urinary tract spasms.
  • Wound healing.
  • Other conditions.
More evidence is needed to rate the effectiveness of butterbur for these uses.

Side Effects

Side Effects & Safety

When taken by mouth: Pyrrolizidine alkaloid (PA)-free butterbur products are POSSIBLY SAFE when taken by mouth appropriately for up to 16 weeks. PA-free butterbur is generally well tolerated. It can cause belching, headache, itchy eyes, diarrhea, upset stomach, fatigue, and drowsiness. But it seems to cause less drowsiness and fatigue than cetirizine (Zyrtec) when taken for allergies. Liver injury occurs rarely.

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. Do not use butterbur products unless they are certified and labeled as free of PAs.

When applied to the skin: Butterbur products that contain PAs are LIKELY UNSAFE when 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. There isn't enough reliable information to know if butterbur is safe to use on unbroken skin or what the side effects might be.

Special Precautions & Warnings:

Children: Pyrrolizidine alkaloid (PA)-free butterbur is POSSIBLY 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.

Interactions

Interactions?

Moderate Interaction

Be cautious with this combination

!
  • Medications that increase break down of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers) interacts with BUTTERBUR

    Butterbur is broken down by the liver. Some chemicals that form when the liver breaks down butterbur can be harmful. Medications that cause the liver to break down butterbur might enhance the toxic effects of chemicals contained in butterbur.

    Some of these medicines include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Dosing

Dosing

The following doses have been studied in scientific research:

ADULT:

BY MOUTH:

  • For hay fever: 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: 75-150 mg of a specific butterbur rhizome extract (Petadolex, Weber & Weber, GmbH & Co) has been taken daily in up to two divided doses for up to 4 months.
  • Emotional distress caused by extreme focus on a physical symptom (somatic symptom disorder): A specific product called Ze185 (Relaxane, Max Zeller Söhne AG) 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) 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.

View References

REFERENCES:

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