Common name:

• Butterbur
• purple butterbur
• Western coltsfoot
• butter dock
• Arctic butterbur
• bog rhubarb
• pestilence wort

Botanical Names

Botanical names:

• Petasites hybridus
• Petasites frigidus

Parts used and where grown

Butterbur, or Petasites hydridus, is found in colder, northern regions of Russia and Europe. A species native to the northern United States and much of Canada is Petasites frigidus. All parts of either plant can be used, including root, rhizome, leaves, and flowers. Both species are easily confused with their close cousin, Eastern coltsfoot (Tussilago farfara), a plant that looks the same and has similar properties and hazards.

Health Concerns

Butterbur has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Hay fever Migraine headache
	Asthma
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Traditional Use

Historical or traditional use (may or may not be supported by scientific studies)

Traditionally the entire plant was used as a demulcent to soothe a dry, spasmodic cough.¹ It was primarily made into a tea, and used only for short periods of time. Using the herb as a tea may have helped reduce the liver's exposure to butterbur's toxic compounds, as they are not normally water soluble.

Active Constituents

Active constituents

Butterbur contains petasins, a group of bitter-tasting compounds in a class of chemicals called sesquiterpenoids. Petasine is a specific petasin considered important in butterbur. Petasins relax blood vessels and various smooth muscles in the body, such as those that are found in the uterus and lungs, according to test tube and animal studies.² Petasins are also known to reduce inflammation, as demonstrated in human studies.³ Because of these properties, butterbur might be expected to be beneficial for people with migraines and asthma. Butterbur extracts have consistently been shown to reduce symptoms in people with migraines more effectively than placebo. Butterbur has also been shown to help people with asthma, although the results have been conflicting.^{4, 5, 6} Some studies have also shown that butterbur extract works just as well as a common antihistamine drug for people with hay fever, but without causing drowsiness.

Butterbur also contains unsaturated pyrrolizidine alkaloids. These can cause severe liver damage in some people if taken for too long. Only extracts that exclude pyrrolizidine alkaloids should be used.

Dosage

How much is usually taken?

The most commonly available product is an extract of the rhizome of Petasites hybridus standardized to contain 7.5 mg of petasine per capsule. This type of extract removes the pyrrolizidine alkaloids to avoid causing liver damage. Intake is usually 1 to 2 capsules three times per day.

Side Effects

Are there any side effects or interactions?

There are no known side effects as long as pyrrolizidine alkaloids are not present. When they are present, they can cause serious liver damage and even liver failure or death. Therefore, pyrrolizidine alkaloid-containing extracts should not be used.

At the time of writing, there were no well-known drug interactions with butterbur.

References

1. Moore M. Medicinal Plants of the Pacific West. Santa Fe NM: Red Crane Books, 1993.
2. Wang GJ, Shum AY, Lin YL, et al. Calcium channel blockade in vascular smooth muscle cells: Major hypotensive mechanism of S-petasin, a hypotensive sesquiterpene from Petasites formosanus. J Pharmacol Exp Ther 2001;297:240-6.
3. Thomet OA, Schapowal A, Heinisch IV, et al. Anti-inflammatory activity of an extract of Petasites hybridus in allergic rhinitis. Int Immunopharmacol 2002;2:997-1006.
4. Lipton RB, Gobel H, Einhaupl KM, et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology 2004;63:2240-4.
5. Lee DK, Haggart K, Robb FM, Lipworth BJ. Butterbur, a herbal remedy, confers complementary anti-inflammatory activity in asthmatic patients receiving inhaled corticosteroids. Clin Exp Allergy 2004; 34:110-4.
6. Ziolo G, Samochewiec L. Study on clinical properties and mechanism of action of petasites in bronchial asthma and chronic obstructive bronchitis. Pharm Acta Helv 1998;72:378-80.

Last Review: 09-01-2007

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2009.