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Butterbur-Free Extract

herb Verified

Specifically for Migraine

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Why it works for Migraine:

Active compounds in butterbur extracts are petasins (petasin, isopetasin) which have anti-inflammatory and neuromodulatory activity. They appear to reduce neurogenic inflammation by inhibiting leukotriene and prostaglandin pathways, desensitizing TRPA1 nociceptors, modulating calcium influx in vascular smooth muscle, and—based on more recent work—interfering with CGRP signalling implicated in migraine. These combined effects plausibly reduce the frequency and intensity of migraine attacks. Frontiers

Clinical rationale: multiple randomized placebo-controlled trials using a standardized, PA-free butterbur root extract (commonly studied as Petadolex® or “special butterbur extract”) reported reductions in monthly migraine frequency vs placebo at the clinically tested dose. That clinical signal supports the biological mechanisms above. Medscape Reference

How to use for Migraine:

Typical trial dose: the most common, evidence-backed dosing used in the randomized trials is 75 mg twice daily (total 150 mg/day) of a standardized butterbur root extract (e.g., Petadolex®) for migraine prevention. Most trials evaluated treatment courses of ~3–4 months. The Neurology randomized trial and later reviews use 75 mg BID as the primary effective dose. Medscape Reference

Formulation: use only PA-free, standardized butterbur root extract (labelled “PA-free” or a known standardized product such as the preparations used in trials). Do not use raw plant material or non-standardized supplements because of pyrrolizidine alkaloid (PA) contamination risk. NCCIH

Treatment duration & assessment: clinicians and trial protocols typically assess effect after 8–12 weeks; if no meaningful reduction in migraine frequency/severity after ~3 months, stop and reassess other prophylactic options. Monitor response (attack frequency, severity, acute medication use). Medscape Reference

Pediatric use: some trials included children/adolescents with lower doses in specific formulations, but safety data are more limited — consult a pediatric neurologist before use. Dove Medical Press

Scientific Evidence for Migraine:

Lipton RB et al., Neurology 2004 — randomized, three-arm trial (placebo, 50 mg bid, 75 mg bid); 75 mg twice daily reduced migraine frequency versus placebo. (Key RCT often cited). Medscape Reference

Diener HC et al., Eur Neurol 2004 — independent re-analysis of an earlier placebo-controlled trial of a special butterbur extract; supports efficacy when proper analysis criteria applied. Karger

Systematic reviews / evaluations — reviews of the evidence summarize that Petasites root extracts (PA-free standardized preparations) reduced migraine frequency in several trials; small number of RCTs but consistent positive signal at 150 mg/day. See the 2006/2007 reviews and later updates. ScienceDirect

2022 Frontiers review (mechanism & updated data) — summarizes mechanism (TRPA1, CGRP, petasin effects) and restates that randomized, double-blind, placebo-controlled trials with Petadolex showed significant reduction in attack frequency at 150 mg/day. Useful for mechanism and modern synthesis. Frontiers

NCCIH (NIH) summary — independent government summary describing the clinical evidence and safety concerns (PA hepatotoxicity); useful, balanced summary for clinicians/patients. NCCIH

Specific Warnings for Migraine:

Pyrrolizidine alkaloids (PAs) — the big safety issue. Raw butterbur contains PAs, which are known hepatotoxic (can cause veno-occlusive liver disease) and are potentially carcinogenic. This is the principal safety concern for butterbur use. Always use PA-free, standardized extracts; manufacturers of clinical products (e.g., Petadolex®) remove PAs to levels below detection. Regulatory authorities and safety reviews emphasize PA risk. MDPI

Regulatory & professional guidance: because of liver-safety concerns, some neurological societies/organizations have stopped recommending butterbur or caution its use unless a PA-free validated product is used and liver safety monitored. The NCCIH and other authorities note this. NCCIH

Reported liver events: there are case reports and pharmacovigilance signals linking butterbur products to liver injury in some settings; reviews differ on causality for specific branded PA-free products, but the consensus is to be cautious and to monitor LFTs if a clinician elects to use butterbur. Several safety reviews examined Petadolex® specifically and discuss the data on liver events and causality. SAGE Journals

Who should avoid butterbur:

  • People with known liver disease or abnormal liver function tests. Medsafe
  • Pregnant or breastfeeding women (insufficient safety data). NCCIH
  • People allergic to ragweed or Asteraceae family (risk of cross-reactivity). NCCIH
  • Avoid concomitant use with other hepatotoxic drugs unless closely supervised by a clinician. MDPI

Monitoring advice (practical):

  • Use only PA-free, standardized butterbur root extract from a reputable manufacturer. Confirm “PA-free” on the product label or manufacturer information. NCCIH
  • Baseline liver function tests (LFTs) before starting; repeat LFTs after a few weeks (provider judgment varies — many recommend checking during the first 1–3 months). Stop immediately if LFTs rise or if symptoms of liver injury (fatigue, jaundice, dark urine, abdominal pain) occur. SAGE Journals
  • Limit duration to the timeframes used in trials (commonly ≤3–4 months), unless a clinician decides longer use is justified and monitors liver function. Long-term safety data are limited. Dove Medical Press+

General Information (All Ailments)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

What It Is

Butterbur-Free Extract refers to a purified herbal extract derived from the Petasites hybridus plant, commonly known as butterbur. Traditionally used in European herbal medicine, butterbur has been valued for its potential benefits in managing migraines, allergies, and respiratory issues.

However, raw butterbur contains compounds called pyrrolizidine alkaloids (PAs), which can be toxic to the liver and harmful to the body. Therefore, “butterbur-free” or “PA-free” extracts have undergone a special purification process to remove these harmful alkaloids, making them safer for human use.

Commercially, the purified extract is standardized to its active components—mainly petasin and isopetasin—which are believed to contribute to its therapeutic effects.

How It Works

Butterbur-Free Extract works primarily through its anti-inflammatory, antispasmodic, and leukotriene-inhibiting properties:

  • Inflammation Reduction: The active compounds petasin and isopetasin inhibit the production of inflammatory mediators, such as leukotrienes, which are involved in allergic and migraine responses. By doing so, the extract may reduce inflammation in nasal passages, airways, and blood vessels.
  • Smooth Muscle Relaxation: Butterbur acts as an antispasmodic, helping relax smooth muscles in the vascular system and respiratory tract. This can lessen vascular constriction involved in migraines and help ease airway irritation during allergic reactions.
  • Histamine and Leukotriene Pathway Modulation: Butterbur appears to block the effects of substances that trigger allergic responses—similar in function to antihistamines, but without causing drowsiness in most people.

Together, these actions may help prevent or lessen the frequency of migraine attacks, reduce nasal allergy symptoms (hay fever), and support respiratory comfort in sensitive individuals.

Why It’s Important

Butterbur-Free Extract is significant because it offers a natural therapeutic alternative for people who experience migraines or seasonal allergies and prefer non-pharmaceutical options. Clinical studies have shown that:

  • Standardized, PA-free butterbur extracts can reduce migraine frequency comparably to certain prescription migraine preventatives (like topiramate or propranolol).
  • In allergy management, it has been shown to improve symptoms of rhinitis similarly to antihistamines—without the common side effect of drowsiness.
  • It supports respiratory and sinus health by calming allergic inflammation and improving breathing comfort during allergy seasons.

The removal of toxic alkaloids (PAs) makes the “butterbur-free” version an important safety advancement, ensuring people can benefit from the herb without risking liver toxicity.

Considerations

While Butterbur-Free Extract can be beneficial, there are several important considerations:

  • Product Quality: Only use certified PA-free extracts. Unpurified butterbur products may contain hepatotoxic compounds that can damage the liver. Trusted brands will indicate “PA-free” or “butterbur-free” on the label.
  • Dosage and Standardization: Follow manufacturer or healthcare provider guidance. Clinical doses for migraine prevention often range around 50–75 mg twice daily of standardized extract (containing 15% petasin and isopetasin).
  • Potential Side Effects: Though rare, some people may experience mild gastrointestinal upset, fatigue, or allergic skin reactions.
  • Pregnancy and Children: Not enough research supports its safety for pregnant or breastfeeding women, or for young children, so use should be avoided unless under medical supervision.
  • Drug Interactions and Liver Health: Individuals with liver disease, or those taking hepatotoxic or enzyme-modifying drugs, should consult a doctor before using butterbur extract—even PA-free versions.

Helps with these conditions

Butterbur-Free Extract is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.

Migraine 0% effective
Allergies (Hay Fever) 0% effective
Chronic Sinusitis 0% effective
3
Conditions
0
Total Votes
17
Studies
0%
Avg. Effectiveness

Detailed Information by Condition

Migraine

0% effective

Active compounds in butterbur extracts are petasins (petasin, isopetasin) which have anti-inflammatory and neuromodulatory activity. They appear to re...

0 votes Updated 2 months ago 5 studies cited

Leukotriene inhibition (petasins): Standardized leaf CO₂ extracts of Petasites hybridus (e.g., Ze 339) inhibit leukotriene biosynthesis—key inflammato...

0 votes Updated 1 month ago 5 studies cited

Chronic Sinusitis

0% effective

Butterbur (Petasites hybridus) extracts — specifically PA-free, standardized leaf extracts such as Ze339 or clinical products like Petadolex — have ra...

0 votes Updated 2 months ago 7 studies cited

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