Remedy · herb
Butterbur
Also: Petasites hybridus
An effective migraine preventive whose raw form is liver-toxic — only PA-free extracts should ever be used.
Evidence by condition
Each grade reflects the research for Butterbur and that condition specifically.
- BMigraine
A PA-free extract (75 mg twice daily) cut migraine frequency about 48% vs 26% placebo — but safety concerns dominate the decision.
2 citation s
- Petasites hybridus root (butterbur) is an effective preventive treatment for migraine Randomized trial 2004 · n=245 · Neurology · PMID 15623680 · DOI 10.1212/01.WNL.0000147290.68260.11
- Butterbur NCCIH · accessed 2026-06-21
- Petasites hybridus root (butterbur) is an effective preventive treatment for migraine
- BAllergic rhinitis (hay fever)
A PA-free extract (Ze 339) repeatedly matched non-sedating antihistamines and beat placebo for allergic rhinitis; only certified PA-free products should be used.
3 citation s
- Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis Randomized trial 2002 · n=125 · BMJ · PMID 11799030 · DOI 10.1136/bmj.324.7330.144
- Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339 Randomized trial 2005 · n=330 · Phytotherapy Research · PMID 16114089 · DOI 10.1002/ptr.1705
- Butterbur NCCIH · accessed 2026-06-21
- Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis
Raw butterbur contains pyrrolizidine alkaloids that are toxic to the liver and potentially carcinogenic. The American Academy of Neurology withdrew its butterbur recommendation in 2015 over these safety concerns. Only certified PA-free extracts should ever be considered, and only with clinician oversight.