Butterbur

© Steven Foster

This fact sheet provides basic information about butterbur—common 

names, what the science says, potential side effects and cautions, and 

resources for more information.

Common Names—butterbur, petasites, purple butterbur. 

Butterbur is also known under several patented standardized extract 

forms, such as Petadolex.

Latin Names—Petasites hybridus (also known as Petasitidis hybridus, 

Petasites officinalis, or Tussilago hybrida).

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 at nccam.nih.gov/timetotalk/. 

Sources

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.

For More Information

Visit the NCCAM Web site at nccam.nih.gov and view Using Dietary Supplements Wisely

(nccam.nih.gov/health/supplements/wiseuse.htm).

NCCAM Clearinghouse

Toll-free in the U.S.: 1-888-644-6226

TTY (for deaf and hard-of-hearing callers): 1-866-464-3615

E-mail: info@nccam.nih.gov

PubMed®

Web site: www.ncbi.nlm.nih.gov/sites/entrez

NIH Office of Dietary Supplements

Web site: www.ods.od.nih.gov

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical 

expertise and advice of your primary health care provider. We encourage you to discuss any decisions about 

treatment or care with your health care provider. The mention of any product, service, or therapy is not an 

endorsement by NCCAM.

National Institutes of Health

♦♦♦

U.S. Department of Health and Human Services

D464

Created December 2011

Updated April 2012