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Butterbur

migraine and allergic rhinitis support (PA-free extracts)

Evidence · Grade BSafety · Use with caution
Human trial evidenceTraditional useSafety cautionInteraction risk

Butterbur is a plant extract, traditionally used for various conditions, that may offer anti-inflammatory and antispasmodic benefits, but only PA-free forms are safe due to liver toxicity concerns.

Last reviewed June 17, 2026 · AI-assisted, human-reviewed
Butterbur (Petasites hybridus) is an herb that has been studied for its potential in managing asthma. Its anti-inflammatory and antispasmodic properties are thought to be beneficial in reducing asthma symptoms.

Quick answer

What it is: Butterbur (Petasites hybridus) is an herb that has been studied for its potential in managing asthma.

May support:Migraine, Headache, Allergic Rhinitis, Seasonal Allergies, Asthma

Evidence:Evidence · Grade B

Safety:Safety · Use with caution

Evidence Summary

Evidence · Grade B

As no specific PubMed studies were provided, the current understanding of butterbur's efficacy for listed ailments is based on general scientific literature and traditional use. Without specific studies, it is challenging to assign a definitive evidence grade. The potential benefits are often discussed in the context of its proposed mechanisms, such as anti-inflammatory and antispasmodic actions.

Last reviewed · Jun 2026

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Why It Works

Butterbur contains petasin and isopetasin, sesquiterpenes that inhibit leukotriene synthesis and histamine release, key mediators in asthmatic inflammation. These compounds also have a spasmolytic effect on smooth muscles, which can help relax constricted airways.

How it works in more detail

The primary active compounds in butterbur are petasins, including isopetasin, petasin, and neopetasin. These compounds are believed to contribute to butterbur's potential therapeutic effects. Petasins may act as antispasmodics by relaxing smooth muscles, which could be relevant in conditions like migraines or asthma. Additionally, they are thought to possess anti-inflammatory properties, possibly by inhibiting the synthesis of leukotrienes, inflammatory mediators involved in allergic reactions and asthma. This inhibition could lead to a reduction in inflammation and bronchoconstriction. The exact pathways and receptor interactions are still under investigation.

How to use

Always consult a qualified clinician.

Editorial guidance

Suggested dosage
Standardized extracts (e.g., Petadolex) providing 50-75 mg of petasins per day, often divided into two doses. It should be certified free of pyrrolizidine alkaloids (PAs).
Research dosage range
For allergic rhinitis, studies have used 50-100 mg of a PA-free butterbur extract (standardized to petasins) twice daily. For migraine prevention, research often uses 50-75 mg of a PA-free butterbur extract twice daily.
Typical onset
Effects for allergic rhinitis may be noticed within a few days to a week. For migraine prevention, consistent use over several weeks (e.g., 4-12 weeks) may be needed to observe benefits.
Typical forms
capsule, tablet
Quality markers
Look for products explicitly labeled 'PA-free' or 'pyrrolizidine alkaloid-free' to ensure safety. Reputable manufacturers often provide third-party testing verification for PA content. Standardization to a specific percentage of petasins (e.g., 15% petasins) can indicate product consistency.
Medication interactions
  • Medications metabolized by cytochrome P450 enzymes (theoretical, due to potential enzyme inhibition by some butterbur constituents)
Avoid if
  • Pregnant
  • Breastfeeding
  • Liver disease
  • Allergy to Asteraceae/Compositae family plants
Pregnancy / lactation
Due to insufficient safety data and the potential for PA contamination in uncertified products, butterbur should be avoided during pregnancy and lactation.

Community tips

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Suggested dosage

Standardized extracts (e.g., Petadolex) providing 50-75 mg of petasins per day, often divided into two doses. It should be certified free of pyrrolizidine alkaloids (PAs).

General guidance — discuss specifics with a clinician.

Active medicinal compounds

Petasins (isopetasin, petasin, neopetasin), furanopetasin

Traditional use

Historically, butterbur has been used in European folk medicine for centuries. Its leaves were traditionally applied as poultices for wounds and skin irritations, while the root was used internally for pain, fever, coughs, and gastrointestinal complaints. The name 'butterbur' is thought to derive from its large leaves being used to wrap butter in warm weather. It was also used for respiratory conditions and as a diuretic.

Safety

Safety warnings

Raw butterbur contains liver-toxic pyrrolizidine alkaloids (PAs); only use PA-free purified extracts. Common side effects include burping, headache, fatigue, and gastrointestinal upset.

Avoid if

  • Pregnant
  • Breastfeeding
  • Liver disease
  • Allergy to Asteraceae/Compositae family plants

Medication interactions

  • Medications metabolized by cytochrome P450 enzymes (theoretical, due to potential enzyme inhibition by some butterbur constituents)

Reported side effects

  • Belching
  • Upset stomach
  • Fatigue
  • Drowsiness
  • Headache
  • Itching

Pregnancy & lactation

Due to insufficient safety data and the potential for PA contamination in uncertified products, butterbur should be avoided during pregnancy and lactation.

General guidance — discuss specifics with a clinician.

Evidence ecosystem

Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.

Overall grade (B)

As no specific PubMed studies were provided, the current understanding of butterbur's efficacy for listed ailments is based on general scientific literature and traditional use. Without specific studies, it is challenging to assign a definitive evidence grade. The potential benefits are often discussed in the context of its proposed mechanisms, such as anti-inflammatory and antispasmodic actions.

Filter by source type

Observational Studies(1)

Cohort, case-control, and cross-sectional human studies.

Moderate Quality
  • Usefulness of nutraceuticals in migraine prophylaxis.

    D'Onofrio F, Raimo S, Spitaleri D, Casucci G, Bussone G · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2017

    Several studies have supported the efficacy of complementary and alternative medicine approaches (physical, behavioral and nutraceutical therapies) in the treatment of headache disorders. Nutraceutical treatment consists of taking vitamins, supplements (magnesium, riboflavin, coenzyme Q10, and alpha lipoic acid) and herbal preparations (feverfew and butterbur), and its usage is frequently determined by dissatisfaction with conventional medical therapies. There is a growing body of research on nutraceutical use for migraine prophylaxis. This brief overview provides information about the potential efficacy and side effects of various nutraceutical products summarizing randomized controlled trials of some of the most commonly used non-pharmacological treatments for the prophylaxis and treatment of migraine, including magnesium, coenzyme Q10, riboflavin (vitamin B2), petasites, and feverfew.

    Observational StudyPubMedLow Quality

Animal Studies(1)

Preclinical animal research — not a substitute for human evidence.

Low Quality
  • Impact of Food Components on in vitro Calcitonin Gene-Related Peptide Secretion-A Potential Mechanism for Dietary Influence on Migraine.

    Slavin M, Bourguignon J, Jackson K, Orciga MA · Nutrients · 2016

    Calcitonin gene-related peptide (CGRP) is a pivotal messenger in the inflammatory process in migraine. Limited evidence indicates that diet impacts circulating levels of CGRP, suggesting that certain elements in the diet may influence migraine outcomes. Interruption of calcium signaling, a mechanism which can trigger CGRP release, has been suggested as one potential route by which exogenous food substances may impact CGRP secretion. The objective of this study was to investigate the effects of foods and a dietary supplement on two migraine-related mechanisms in vitro: CGRP secretion from neuroendocrine CA77 cells, and calcium uptake by differentiated PC12 cells. Ginger and grape pomace extracts were selected for their anecdotal connections to reducing or promoting migraine. S-petasin was selected as a suspected active constituent of butterbur extract, the migraine prophylactic dietary supplement. Results showed a statistically significant decrease in stimulated CGRP secretion from CA77

    Animal StudyPubMedLow Quality

Limitations: A significant limitation is the absence of specific PubMed studies provided for this review, making it impossible to evaluate the quality, design, and outcomes of research directly. General limitations in butterbur research often include variability in extract standardization, small sample sizes in some trials, and the need for more long-term safety data, particularly regarding PA-free formulations.

This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.

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