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In studies and postmarketing surveillance involving adults and children, burping and other mild gastrointestinal complaints have been the main side effect of butterbur extract. 1 Butterbur contains liver-toxic and possibly carcinogenic components called pyrrolizidine alkaloids. 2 Fortunately, it is possible to remove these compounds from butterbur products. 3 In Germany, the maximum allowable content of pyrrolizidine alkaloids in butterbur products has been set at 1 microgram per daily recommended dose.
Butterbur should not be used by pregnant or nursing women, young children, or people with severe kidney or liver disease, until further safety testing has been performed.
- Lipton RB, Gobel H, Einhaupl KM, et al. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology. 2004;63:2240-4..
- Luthy J, Zweifel U, Schmid P, et al. Pyrrolizidine alkaloids in Petasites hybridus L. and P. albus L. [in German; English abstract]. Pharm Acta Helv. 1983;58:98–100.
- Mauz C, Candrian U, Luthy J, et al. Method for the reduction of pyrrolizidine alkaloids from medicinal plant extracts [in German; English abstract]. Pharm Acta Helv. 1985;60:256–259.