Herbs and plantsButterbur — an herb for allergies and migraines with a hidden risk?
- Henryk Różański — Lepiężnik – Petasites w leczeniu stanów zapalnych, alergii i jako spasmolyticum
- Henryk Różański — Lepiężnik – Petasites w praktycznej fitoterapii
- Henryk Różański — Podbiał – Tussilago farfara Linne
- Efficacy and Safety of P. hybridus Leaf Extract Ze 339 for the Treatment of Allergic Rhinitis. · Adv Respir Med 2025
- Evaluation of the antimigraine and anti-neuroinflammatory activity of purified constituents of Petasites hybridus L. in a migraine-like pain model in mice. · Inflammopharmacology 2026
- Petasites for Migraine Prevention: New Data on Mode of Action, Pharmacology and Safety. A Narrative Review. · Front Neurol 2022
Henryk Różański advises not using butterbur regularly for longer than 2–3 weeks because it contains pyrrolizidine alkaloids.
- Butterbur preparations relieve allergy symptoms and are sometimes recommended for migraine prevention.
- According to Różański, commercial preparations are stripped of unwanted alkaloids and standardized for sesquiterpene content; the raw material contains up to 0.04% alkaloids and is safe to use.
- However, the preparation may cause an allergic reaction in people who are hypersensitive, and Różański advises them to stop treatment.
What the authors write
Butterbur preparations relieve allergy symptoms and are sometimes recommended for migraine prevention.
Butterbur’s components are thought to inhibit several processes involved in allergic reactions.
Henryk Różański advises that regular use should not continue for longer than 2–3 weeks because butterbur contains pyrrolizidine alkaloids.
Commercial butterbur preparations are stripped of unwanted alkaloids and standardized for sesquiterpene content.
Henryk Różański states that the pyrrolizidine alkaloid content is low, up to 0.04%, and on this basis considers the raw material safe to use.
A butterbur preparation may cause an allergic reaction in people who are hypersensitive; in that case, Henryk Różański advises stopping treatment.
Henryk Różański advises against combining butterbur with coltsfoot, ragworts, and comfrey because their pyrrolizidine alkaloid content would add up.
Henryk Różański gives extract doses used for allergies and for relieving and preventing migraines.
Research from PubMed · Europe PMC
We selected 3 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 3.
A review indicates that the butterbur leaf extract Ze 339 may relieve symptoms of allergic rhinitis and offer an alternative to antihistamines.
Aim of the study: Allergic rhinitis (AR) is a growing global health problem. More and more people are affected, and climate change is worsening this health problem over the long term.
Results: More than two decades after it was first launched on the market, it is now possible to draw meaningful conclusions about its safety and efficacy. This review summarizes the available preclinical and clinical data, real-world data (RWD), and data from post-marketing pharmacovigilance monitoring on the herbal medicinal product Ze 339. It focuses on current knowledge about how it works and on evaluating its efficacy and safety in treating AR. Given its favourable safety profile and lack of sedative side effects, Ze 339 offers a valuable alternative to antihistamines and should therefore continue to be considered by medical practitioners for treating allergic rhinitis symptoms.
“Not stated” does not mean nobody paid — the database does not always record it.
In a mouse study, isopetasin reduced pain hypersensitivity in a migraine model.
Aim of the study: Migraine is a common neurovascular disorder strongly associated with neuroinflammation, altered neurotransmitter release, and sensory hypersensitivity. Extracts of Petasites hybridus (butterbur) rootstocks, standardized for eremophilane-type sesquiterpenoids (petasins), have shown clinical efficacy in migraine.
Results: In vitro, sesquiterpenoids suppressed LPS-induced nitric oxide and pro-inflammatory cytokine release, with isopetasin showing the broadest anti-inflammatory activity. Neurochemical profiling revealed changes in glutamic acid and GABA associated with the excitatory/inhibitory balance. Purified petasins from butterbur rootstocks, particularly isopetasin, show significant pain-relieving and anti-inflammatory activity in preclinical migraine models. These findings support the importance of well-defined butterbur constituents and provide a basis for further investigation of their use as anti-neuroinflammatory agents.
“Not stated” does not mean nobody paid — the database does not always record it.
A review describes possible ways butterbur works in migraine, and animal studies found no harmful effect on the liver at a therapeutic dose.
Aim of the study: Petasins are the pharmacologically active ingredients of butterbur and provide therapeutic benefits in treating migraine and tension headaches. Here, we summarize the pharmacology, safety, and clinical efficacy of butterbur in preventing migraine attacks and present new data on how it works.
Results: At supratherapeutic doses—that is, 45–90 times the MCD—we observed bile duct hyperplasia, and mechanistic studies found changes in solute carriers that are likely to account for bile duct proliferation. In addition, liver function tests in cultures of primary human hepatocytes showed no evidence of hepatotoxicity at therapeutic butterbur levels or when used with migraine medications. Finally, in randomized, double-blind, placebo-controlled trials, Petadolex® significantly reduced migraine attack frequency at 150 mg/day, and no relevant abnormal liver function was reported. Taken together, butterbur prevents migraine attacks effectively by blocking CGRP signaling.
“Not stated” does not mean nobody paid — the database does not always record it.
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