Butterbur

Are there any interactions with medications?

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Medications that increase breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Butterbur is broken down by the liver. Some chemicals that form when the liver breaks down butterbur can be harmful. Medications that cause the liver to break down butterbur might enhance the toxic effects of chemicals contained in butterbur.

Some of these medicines include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Dosing considerations for Butterbur.

The following doses have been studied in scientific research:

BY MOUTH:

• For preventing migraine headache: a specific butterbur rhizome extract (Petadolex, Weber&Weber, GmbH & Co, Germany) has been used in doses of 50 to 100 mg twice daily with meals. Higher doses seem to be work better. Lower doses of 50 mg twice daily may not be effective in adults. Some researchers suggest taking the extract for 4-6 months, then lowering the dose over time until the number of migraines begins to increase again. That dose would be the recommended one. In 6-9 year-old children with migraine, a dose of 25 mg twice daily has been used; 50 mg twice daily has been used in older children. Three times daily dosing has been used in children who don't respond to the twice daily dose.
• For hay fever (allergic rhinitis): a specific butterbur extract (ZE 339, Zeller AG) one tablet 3-4 times daily has been used. A whole butterbur root extract (Petaforce) in a dose of 50 mg twice daily has also been used for hay fever.