Butterbur (Petasites) is an ancient plant that has been and continues to be used for medical and edible purposes. The mechanism by which butterbur may reduce migraine includes inhibiting the inflammatory effect of chemicals like leukotrienes and prostaglandin E2 in the pain pathway. Another mechanism of butterbur may be its ability to function as a natural beta blocker which results in the normal flow of blood to the brain. This helps control blood pressure and spasmodic capillary action, which can also contribute to the onset of migraine headaches.
One study of 245 patients over 4 months of treatment demonstrated that petasites extract 75 mg twice daily is more effective than placebo and is well tolerated as a preventive therapy for migraine.
From a pooling of data, the recommended adult dosage is 50-100 mg twice daily to reduce migraine headache symptoms and to prevent future migraine headaches. Three months is considered an adequate amount of time to observe the efficacy of butterbur.
When purchasing butterbur products, be sure to choose a brand labeled PA-Free. This means the product was processed to remove potentially harmful or toxic chemicals found in the butterbur plant known as pyrrolizidine alkaloids (PA). The special butterbur extract is prepared by having all liver-toxic alkaloids removed.
Please consult your healthcare practitioner to avoid interactions between other medications you may be taking. Avoid using butterbur if you are pregnant or breast-feeding or allergic to ragweed, daisies, chrysanthemums or marigolds. Adverse reactions can include mild stomach upset and commonly, belching.
By: Dr. Sandy Cho, MD
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- Aydın AA, Zerbes V, Parlar H, Letzel T. The medical plant butterbur (Petasites): analytical and physiological (re)view. J Pharm Biomed Anal 2013;75:220-9.
- Diener HC, Rahlfs VW, Danesch U. The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: reanalysis of efficacy criteria. Eur Neurol 2004;51(2):89-97.
- Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology 2004;63(12):2240-4.