Petasites hybridus - Butterbur

Alternative Medicine Review, April, 2001

Gastrointestinal Disorders

Butterbur's use as an antispasmodic for gastrointestinal conditions dates back to the Middle Ages. The leaves and rhizomes were used to treat spasms of the digestive tract associated with colic, plague, and bile flow obstruction.[9,10] A German study conducted in 1993 found ethanolic extracts of Petasites hybridus blocked ethanol-induced gastric damage and reduced ulcerations of the small intestine caused by indomethacin, an anti-inflammatory drug used to treat arthritic conditions. The results of this study were attributed to inhibition of lipoxygenase activity and leukotriene biosynthesis.[11]

Safety

Until recently, side effects from Petasites extracts had not been reported. In September 2000, a study conducted in Taiwan noted the petasin constituent, responsible for many of butterbur's pharmacological properties, inhibited the production of testosterone in rat testicular cells, but did not speculate whether this effect would be applicable in humans.[12] The plant's pyrrolizidine alkaloids are thought to cause liver damage and to be carcinogenic in animals; however, extracts are commercially available in which the pyrrolizidine alkaloids have been removed. There are no known interactions with either pharmaceutical or over-the-counter anti-inflammatory agents; however, use of Petasites extracts during pregnancy and lactation is contraindicated.[1]

Dosage

Typically, Petasites extracts are standardized to contain a minimum of 7.5 mg of petasin and isopetasin. The adult dosage ranges from 50-100 mg twice daily with meals. When used to treat migraines, administration is prophylactic and supplementation should be carried out daily for four to six months and then tapered until migraine incidence begins to increase. Dosage regimens for asthma and gastrointestinal disorders are as yet undefined, dictating the need for further research.

References

[1.] Eaton J. Butterbur, herbal help for migraine. Nat Pharm 1998;2:1,23-24.

[2.] Mauskop, A. Petasites hybridus: ancient medicinal plant is effective prophylactic treatment for migraine. Townsend Lett 2000;202:104-106.

[3.] Grieve M. Butterbur. In: Leyel CF, ed. A Modern Herbal, electronic version. New York, NY: Dover Publications, Inc. 1971.

[4.] Reglin F. A clinical review: Petadolex [R] (Standardized Butterbur Extract), Praxis-Telegram, Nr. 1/98:13-14.

[5.] Bickel D, Roder T, Bestmann HJ, Brune K. Identification and characterization of inhibitors of peptido-leukotriene synthesis from Petasites hybridus. Planta Med 1994;60:318-322.

[6.] Mauskop A, Grossmann WM, Schmidramsl H. Petasites hybridus (butterbur root) extract is effective in the prophylaxis of migraines. Results of a randomized, double-blind trial. J Head Face Pain 2000;40:4.

[7.] Grossmann WM, Schmidramsl H. An extract of Petasites hybridus is effective in the prophylaxis of migraine. Int J Clin Pharmacol Ther 2000;38:430-435.

[8.] Ziolo G, Samochowiec L. Study on clinical properties and mechanism of action of Petasites in bronchial asthma and chronic obstructive bronchitis. Pharmaceutica Acta Helvetica 1998;72:359-380.