Butterbur - Benefits and Uses of Butterbur

Butterbur is derived from the rhizome, or rootstock, and leaves of the perennial shrub Petasites hybridus. It contains sesquiterpene lactones such as pestacins, angelicoyleneopetasol, fukione, and fukinolide. The antispasmodic and analgesic actions may result from the effects of pestacins on prostaglandin synthesis. Butterbur also contains volatile oils, pectin, mucilage, inulin flavonoids, and tannins.

Butterbur contains pyrrizolidine alkaloids, which are carcinogens and hepatotoxins. Butterbur is available as capsules, dried herb, and dried root in products such as Petadolex Standardized Extract.

Benefits And Uses of Butterbur

Butterbur is used as an antispasmodic and analgesic. As an antispasmodic, it's used to treat urinary tract spasms, mild kidney stone disease, bile flow obstruction, dysmenorrhea, colic, bronchospasm, and cough. As an analgesic, it's used for backache, tension, and migraine headache.

Administration

Capsules containing 50 mg of butterbur root extract for example, Petadolex: 50 mg by mouth two times a day for migraine headache .

GI disorders: 5 to 7 g of dried herb by mouth every day.

Side Effects of Butterbur

Butterbur may be associated with sedation, hepatotoxicity, and cancer. It may have added anticholinergic adverse effects if used with antihistamines, atropine, phenothiazines, scopolamine, and tricyclic antidepressants.

If patient is pregnant or breast-feeding or has liver disease, butterbur is contraindicated because of its pyrrizolidine alkaloid content and antispasmodic effect.

Clinical considerations

Because the pyrrizolidine alkaloids in butterbur are toxic, advise patient not to use herb for longer than 4 to 6 weeks annually.

Monitor liver function, as indicated. Warn patient that many references discourage the use of oral butterbur because of liver toxicity associated with the primary component (pyrrizolidine alkaloid).

Instruct patient to stop using butterbur immediately if he experiences skin discoloration, abdominal pain, nausea, or vomiting.

Butterbur may be unsafe for children.

If patient is pregnant or breast-feeding or is planning pregnancy, advise her not to use butterbur.

Warn the patient not to delay treatment for an illness that doesn't resolve after taking butterbur.

Tell patient to remind prescriber and pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription.

Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

One German study showed a reduction in migraine severity and frequency after 4 weeks' treatment with butterbur. It suggests that patients with migraine may benefit from Petadolex prophylactic treatment.

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