Butterbur Supplement Review

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  Evaluated for:
Effectiveness Rating Effectiveness Rating
Migraine prevention
+2 (Moderate Evidence)


  • Many of the medications for preventing migraines have fairly significant side effects. Butterbur seems to be at least as good as these traditional therapies.
  • Butterbur relaxes blood vessels and has anti-inflammatory properties. These properties address the two main biological causes of migraines.
  • In one trial, 70% of patients who used butterbur reduced the frequency of their migraines by about half within four months.
  • Butterbur is typically well tolerated, with few reported side effects.


  • Many people who suffer from migraines improve with a placebo. Patients may also benefit from meditation practice. Rates of improvement with butterbur seem to be only slightly better.
  • The butterbur plant contains a liver toxin called pyrrolizidine alkaloid. This toxin needs to be removed and the butterbur product needs to be purified before it can be brought safely to market, so use only purified products.
  • Future studies are needed to confirm the benefits.

Due to the risk of potential long-term liver toxicity, under no circumstances should you ever ingest raw, unprocessed butterbur plant. This means you should not take butterbur as a tea, capsule of raw herb, or unprocessed tincture. Sensible caution should be exercised in patients with a known allergy/hypersensitivity to related plants such as ragweed, marigolds, daisies, and chrysanthemums.

DOSAGE:We recommend taking 50 to 75 mg dosed twice daily for up to four months. Look for a “pyrrolizidine-free” butterbur rhizome extract with 7.5 mg of petasin and isopetasin in each 50 mg tablet, such as in Petadolex®.

CONCLUSION:Butterbur seems to be a promising prophylactic treatment for the prevention of migraines. A majority of people who use it to prevent migraines will receive some benefit. Whether the benefit is due to an active ingredient or to the placebo effect is not certain, but it still seems worth a try.

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Agosti, R. et al. Effectiveness of Petasites hybritus preparations in the prophylaxis of migraine: A systematic review. Phytomedicine (2006) 13, 743-746
Pothmann, R., Danesch, U. et al. Migraine Prevention in Children and Adolescents: Results of an Open Study With a Special Butterbur Root Extract. Headache (2005) 45:196-203
Lipton, R.B. et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology (2004) 63:2240-2244
Schapowal, A. et al. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ (2002) 324:1-4
Danesch, U., Rittinghausen, R. et al. Safety of a Patented Special Butterbur Root Extract for Migraine Prevention. Headache (2003) 43:76-78
Diener, H.C. 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) 51:89-97
Schapowal, A. et al. Treating Intermittent Allergic Rhinitis: A Prospective, Randomized, Placebo and Antihistamine-controlled Study of Butterbur Extract Ze 339. Phytother. Res. (2005) 19, 530-537

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