Butterbur (petasites hybridus) is the generic name for a family of plants long used by Native Americans and Northern Europeans to treat headaches and inflammation. These daisy-family plants have also been used for allergy treatment.

A study published about a decade ago in the British Medical Journal compared the effectiveness of butterbur extract versus the antihistamine drug, cetirizine (Zyrtec), for the control of symptoms of seasonal allergic rhinitis (“hay fever”). Recruiting patients from Switzerland and Germany, investigators randomly selected a segment of the  patients to receive butterbur extract, while others were given the pharmaceutical treatment. Butterbur was taken four times daily, while  cetirizine just once per day. After two weeks of treatment, subjects were questioned extensively about the symptoms they experienced. Investigators found no significant differences between the two groups of subjects, and concluded that butterbur was just as effective for the control of seasonal allergy symptoms as the standard drug, cetirizine. One difference, however, was a mild sedating effect noted by subjects taking the cetirizine before bedtime.

Although cetirizine is not supposed to be sedating, investigators concluded that butterbur did the job just as well, without inducing drowsiness.

How It Works

Laboratory analyses indicate some of the active compounds in butterbur, called petasines, inhibit the synthesis of leukotrienes. Leukotrienes are immune system chemicals implicated in perpetuating the inflammation associated with allergic rhinitis. Modern drugs specific targeting this inflammatory mediator, known as leukotriene modifiers, are currently used to prevent allergy-induced asthma and/or allergic rhinitis.

Of course, one isolated study is insufficient to firmly establish the safety and effectiveness of a new treatment. In subsequent years, other researchers published similar research, which reached similar conclusions. Scientists in Scotland, for instance, conducted a small study in which patients received either butterbur extract or the prescription (now over-the-counter) antihistamine drug, fexofenadine (e.g. Allegra).

 This time, the subjects took their assigned treatments for one week before reporting to the lab for an objective test to measure the extent of their allergic response to a substance known to induce allergic symptoms. The degree to which nasal passages swelled and constricted airflow was objectively measured among all subjects. Investigators noted no significant difference between subjects who took the butterbur extract and subjects who blindly received the antihistamine drug. Both treatments yielded significantly better symptom control than placebo. This confirmed what the study published earlier in the British Medical Journal  previously reported: butterbur works just as well as common antihistamine drugs for the control of the symptoms of seasonal and perennial allergic rhinitis.

Safe and Efficacious

Another subsequent study assessed the safety, tolerability, and effectiveness of butterbur leaf? extract for the treatment of seasonal allergic rhinitis. Butterbur was judged to be “safe and efficacious,” having delivered improvement in the symptoms of allergy among 90 percent of patients. An overwhelming majority of patients also gave high marks for improvements in quality of life due to the use of butterbur.

While the data is encouraging point out that further independent testing needs to be conducted to verify existing results(as three large clinical trials received financial support from a manufacturer of butterbur extract).

Despite this caveat, available research shows that butterbur does, in fact, offer non-sedating relief from the symptoms of seasonal allergic rhinitis that is comparable to that of approved antihistamine drugs, such as cetirizine and fexofenadine.