Butterbur is a shrub that grows in North America, Europe, and parts of Asia. It has been used to treat migraines and hay fever. It can be taken as a pill or powder.
25 milligrams 1 to 2 times daily.
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
It may be safe to take pyrrolizidine alkaloid-free butterbur for a short time. Butterbur that contains these toxic chemicals may be harmful to the liver and other organs. Not enough studies have been done to say whether it is safe to take butterbur for a long period.
Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:
A. Allergic Rhinitis
A1. Schapowal A, Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002 Jan 19;324(7330):144-146.
A2. Schapowal A, Petasites Study Group. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Arch Otolaryngol Head Neck Surg. 2004 Dec;130(12):1381-1386.
A3. Giles M, Ulbricht C, et al. Butterbur: an evidence-based systematic review by the natural standard research collaboration. J Herb Pharmacother. 2005;5(3):119-143.
A4. Schapowal A, Study Group. Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339. Phytother Res. 2005 Jun;19(6):530-537.
B1. Grossman W, Schmidramsl H. An extract of Petasites hybridus is effective in the prophylaxis of migraine. Altern Med Rev. 2001 Jun;6(3):303-310.
B2. Diener HC, Rahlfs VW, et al. 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.
B3. Lipton RB, Göbel H, et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology. 2004 Dec 28;63(12):2240-2244.
B4. Giles M, Ulbricht C, et al. Butterbur: an evidence-based systematic review by the natural standard research collaboration. J Herb Pharmacother. 2005;5(3):119-143.
B5. Agosti R, Duke RK, et al. Effectiveness of petasites hybridus preparations in the prophylaxis of migraine: a systematic review. Phytomedicine. 2006 Nov;13(9-10):743-746.
B6. Orr SL, Venkateswaran S. Nutraceuticals in the prophylaxis of pediatric migraine: Evidence-based review and recommendations. Cephalalgia. 2014 Jul;34(8):568-583.
C1. Migraine prophylaxis in adults. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T253050/Migraine-prophylaxis-in-adults. Updated November 19, 2018. Accessed March 27, 2019.
Last reviewed March 2019 by EBSCO CAM Review Board Last Updated: 3/4/2020