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Butterbur (Petasites hybridus) is a shrub. Its large leaves were used to wrap butter during warm weather, giving it the name "butterbur".

Butterbur grows throughout Europe and parts of Asia. It's also now found in parts of the US. Butterbur contains chemicals that might relieve spasms and decrease swelling.

Butterbur is used for migraine, hay fever, asthma, and many other conditions, but there is no strong scientific evidence to support most of these uses.

Some butterbur products may contain pyrrolizidine alkaloids (PAs). These chemicals can harm the liver and cause serious side effects. Do not use butterbur products unless they are certified as free of PAs.

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When taken by mouth: Butterbur products that do not contain pyrrolizidine alkaloids (PAs) are possibly safe when used for up to 16 weeks. Side effects might include belching, headache, itchy eyes, diarrhea, upset stomach, and drowsiness.

Some butterbur products may contain PAs. These products are likely unsafe. PAs can damage the liver and lungs and possibly cause cancer. Do not use butterbur products unless they are certified as free of PAs.

When applied to the skin: There isn't enough reliable information to know if butterbur is safe to use or what the side effects might be. Butterbur products that contain PAs are likely unsafe when applied to broken skin. Do not use butterbur products unless they are certified as free of PAs.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There isn't enough reliable information to know if butterbur is safe to use when pregnant or breast-feeding. Butterbur products that contain dangerous chemicals called pyrrolizidine alkaloids (PAs) are likely unsafe to use when pregnant or breast-feeding. PAs might cause birth defects and liver damage.

Children: Butterbur products that do not contain PAs are possibly safe when taken by mouth appropriately. There is some evidence that a specific PA-free butterbur rhizome extract (Petadolex, Weber & Weber, GmbH & Co) can be safely used for up to 4 months in children aged 6-17 years.

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: Butterbur might make liver disease worse. Don't take butterbur if you have liver disease.

Medications that increase break down of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers)

Interaction Rating=Moderate Be cautious with this combination.

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.

Herbs that contain hepatotoxic pyrrolizidine alkaloids (PAs): Butterbur contains PAs, dangerous chemicals that can harm the liver. Taking it along with other supplements that also contain these chemicals might increase the chance of developing serious side effects, including liver damage and cancer. Examples of supplements containing PAs include alkanna, coltsfoot, comfrey, and groundsel.
Herbs that increase the breakdown of other herbs by the liver: Some herbs affect the way the liver processes chemicals such as pyrrolizidine alkaloids (PAs). These herbs might cause the liver to turn PAs into chemicals that are even more poisonous. Herbs that can affect the liver in this way include echinacea, garlic, licorice, St. John's wort, and schisandra.

There are no known interactions with foods.

Butterbur extracts have most often been used by adults in doses of 50-150 mg by mouth daily. Speak with a healthcare provider to find out what dose might be best for a specific condition.

Some butterbur products may contain pyrrolizidine alkaloids (PAs). These products are likely unsafe. Do not use butterbur products unless they are certified and labeled as free of PAs.

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

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