How does butterbur work for migraines?

Butterbur's active compounds, petasin and isopetasin, work through multiple mechanisms to prevent migraines. These compounds inhibit calcium channels, reducing smooth muscle spasms and blood vessel constriction. Petasin also demonstrates anti-inflammatory effects by inhibiting leukotriene synthesis, which contributes to inflammatory responses. Additionally, butterbur appears to modulate neurogenic inflammation and may affect serotonin receptors involved in migraine pathophysiology. Evidence Level B supports these mechanisms in clinical trials for migraine prevention.

Does butterbur interact with any medications?

Butterbur may interact with medications metabolized by the liver, as even PA-free products require hepatic processing. Patients taking hepatotoxic medications, including high-dose acetaminophen, certain antibiotics, and statins, should exercise caution. Butterbur may potentiate effects of antihistamines and blood pressure medications. Because butterbur affects calcium channels, it could theoretically interact with calcium channel blockers. Always consult a healthcare provider before combining butterbur with prescription medications. Evidence Level: C (theoretical interactions based on pharmacology).

What is the recommended dosage for butterbur?

For migraine prevention, the standard adult dosage is 50-75mg of PA-free butterbur extract taken twice daily, typically with meals to reduce gastrointestinal upset. This dosage has Evidence Level B support from clinical trials. For allergic rhinitis, similar dosages have shown effectiveness in 2-4 week trials. Only PA-free (pyrrolizidine alkaloid-free) certified products should be used, as non-PA-free butterbur can cause serious liver damage. Pediatric dosing has not been well-established.

Is butterbur safe to take during pregnancy?

Butterbur is considered unsafe during pregnancy and breastfeeding. Pyrrolizidine alkaloids (PAs) are hepatotoxic and potentially carcinogenic—these compounds can cross the placenta and pass into breast milk. Even PA-free products lack sufficient safety data for pregnant or nursing women. Additionally, butterbur's effects on smooth muscle and blood vessels could theoretically affect pregnancy. Women who are pregnant, planning pregnancy, or breastfeeding should avoid butterbur entirely. Evidence Level: D (insufficient human data; theoretical risk).

What are the side effects of taking butterbur?

Common side effects of PA-free butterbur include gastrointestinal upset, belching, headache, and fatigue, which are generally mild and often resolve with continued use. Serious concerns arise from products containing pyrrolizidine alkaloids (PAs), which can cause severe liver damage, including hepatic veno-occlusive disease. Only certified PA-free products should be used. Individuals with liver disease should avoid butterbur entirely. Allergic reactions may occur in people sensitive to plants in the Asteraceae family, such as ragweed or daisies. Evidence Level: B.

Butterbur (Petasites hybridus)

Qu'est-ce qu'une interaction plante-médicament ?

Une interaction plante-médicament se produit lorsqu'une plante ou un complément modifie l'action d'un médicament dans votre organisme — en le rendant plus puissant, moins efficace, ou plus susceptible de provoquer des effets nocifs. Les plantes contiennent des composés actifs qui peuvent accélérer ou ralentir les enzymes et transporteurs utilisés pour métaboliser les médicaments.

Pourquoi c'est important

Millepertuis peut rendre la contraception, les antidépresseurs et les anticoagulants moins efficaces.

Ail peut augmenter le risque de saignement avec la warfarine et autres anticoagulants (aussi ginkgo, gingembre et curcuma).

Kava peut amplifier la sédation avec les médicaments contre l'anxiété ou le sommeil (aussi la valériane).

Le risque est plus élevé chez les personnes âgées, ceux qui prennent plusieurs médicaments et les personnes atteintes de maladies chroniques.

Indiquez toujours à votre médecin et à votre pharmacien toutes les plantes et compléments que vous prenez — et vérifiez ci-dessous avant toute association.

Interactions Médicamenteuses Connues (1)

1 Léger

Médicament	Sévérité	Description
CYP3A4 substrates	Léger	Le pétasite peut inhiber l'enzyme CYP3A4, augmentant potentiellement les taux sanguins de médicaments métabolisés par cette voie.

Cette liste reflète un sous-ensemble sélectionné d'interactions documentées et n'est pas exhaustive. L'absence d'un médicament ici ne prouve pas qu'il est sans danger à combiner. Confirmez toujours auprès d'un pharmacien ou d'un professionnel de santé.

Fiche d'information compilée à partir de PubMed

Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.

Compilé à partir de 28 articles PubMed · modèle : gemma4:31b

Résumé

Butterbur (Petasites hybridus) is an herbal supplement used primarily for the prophylaxis of adult migraines [PMID:30725845] and the treatment of allergic rhinitis [PMID:30725845, PMID:36088149].

Contexte

Butterbur is a perennial shrub found in Europe, Asia, and North America, typically growing in wet, marshy ground or damp forests [PMID:11302783]. It is derived from the leaves or roots of the Petasites hybridus plant [PMID:30725845].

Usages traditionnels

Historically used in Asian and European traditional medicine for central nervous system (migraine), respiratory (asthma, allergic rhinitis, bronchitis, spastic cough), cardiovascular (hypertension), gastrointestinal (ulcers), and genitourinary (dysmenorrhea) disorders [PMID:35427728]. During the Middle Ages, it was used for plague and fever, and in the 17th century for cough, asthma, and skin wounds [PMID:11302783].

Composés actifs

The primary pharmacologically active ingredients are petasins (eremophilane-type sesquiterpenes) [PMID:35585841, PMID:37364450]. Other constituents include sesquiterpene hydrocarbons such as petasitene and pethybrene [PMID:11937157], as well as naturally occurring pyrrolizidine alkaloids (PAs) [PMID:30725845, PMID:32486467].

Mécanisme d'action

Butterbur inhibits the synthesis of cysteinyl-leukotrienes and decreases intracellular calcium concentrations [PMID:12808361, PMID:16463791]. It diminishes inflammatory mediators by inhibiting cyclooxygenases, lipoxygenases, and phospholipase A2, and desensitizes nociception by acting on TRPA1 and TRPPV1 ion channels [PMID:35585841]. Additionally, it inhibits the release of calcitonin-gene related peptide (CGRP) from meningeal afferents during migraine attacks [PMID:35585841].

Preuves cliniques

Preuve BMigraine Prophylaxis

A randomized trial found that a 75 mg bid dose of standardized root extract reduced migraine attack frequency by 48% over 4 months compared to 26% for placebo [PMID:15623680]. The American Headache Society has given it a level A recommendation for effectiveness in preventing migraine headaches [PMID:30725845].

Preuve CAllergic Rhinitis

Butterbur is cited as one of the therapies with the strongest evidence for the treatment of allergy and allergic rhinitis [PMID:36088149].

Sécurité et effets indésirables

Butterbur contains pyrrolizidine alkaloids (PAs) which are potentially hepatotoxic and carcinogenic [PMID:12808361, PMID:32486467]. Preparations processed to remove PAs do not appear to cause liver injury [PMID:30725845]. However, some reports associate long-term administration with reversible cholestatic hepatitis [PMID:12808361]. Other side effects may involve the gastrointestinal tract [PMID:12808361].

Posologie et administration

In one clinical trial for migraine prevention, doses of 75 mg bid and 50 mg bid of standardized root extract were used [PMID:15623680]. No PubMed data available. Consult a healthcare provider.

Synthèse des preuves

There is strong evidence (Level A/B) supporting the use of butterbur for migraine prophylaxis, provided the extract is processed to remove pyrrolizidine alkaloids. Evidence for allergic rhinitis is positive but less detailed in the provided abstracts.

Sources PubMed

1.PMID: 26252585 (2015) — Preventive Migraine Treatment. · Continuum (Minneapolis, Minn.)
2.PMID: 39853578 (2025) — Nutraceuticals and Headache 2024: Riboflavin, Coenzyme Q10, Feverfew, Magnesium, Melatonin, and Butterbur. · Current pain and headache reports
3.PMID: 32310327 (2020) — Herbal treatments for migraine: A systematic review of randomised-controlled studies. · Phytotherapy research : PTR
4.PMID: 30725845 (2026) — Nutraceuticals in migraine. · Handbook of clinical neurology
5.PMID: 24867850 (2014) — Herbal therapy in migraine. · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

Butterbur

Sources et citations

Feverfew

White Willow

Devil's Claw

⚠️ Non recommandé pendant la grossesse ou l'allaitement

1 interaction médicamenteuse connue — Certaines peuvent être graves

Contre-indications

Effets secondaires possibles

Qu'est-ce qu'une interaction plante-médicament ?

Interactions Médicamenteuses Connues (1)

Résumé

Contexte

Usages traditionnels

Composés actifs

Mécanisme d'action

Preuves cliniques

Sécurité et effets indésirables

Posologie et administration

Synthèse des preuves

Sources PubMed

Sources gouvernementales

Butterbur

Sources et citations

Plantes associées

Feverfew

White Willow

Devil's Claw

⚠️ Non recommandé pendant la grossesse ou l'allaitement

1 interaction médicamenteuse connue — Certaines peuvent être graves

Contre-indications

Effets secondaires possibles

Qu'est-ce qu'une interaction plante-médicament ?

Interactions Médicamenteuses Connues (1)

Résumé

Contexte

Usages traditionnels

Composés actifs

Mécanisme d'action

Preuves cliniques

Sécurité et effets indésirables

Posologie et administration

Synthèse des preuves

Sources PubMed

Sources gouvernementales