Effects of butterbur treatment in intermittent allergic rhinitis: a placebo-controlled evaluation
Annals of Allergy, Asthma & Immunology
Placebo-controlled crossover trial found no significant symptom or airflow benefit, supporting low confidence.
Reviewed guidance
Several trials of standardized butterbur extracts reported improvement in seasonal allergic-rhinitis symptoms, but results are inconsistent and the evidence is product-specific. Safety concerns about pyrrolizidine alkaloids and rare liver injury substantially limit routine use.
Short-term relief of intermittent seasonal allergic-rhinitis symptoms using a standardized oral butterbur extract comparable to studied PA-free medicinal products.
How to use it: Do not use raw butterbur, homemade butterbur tea, or an unlabeled extract. If butterbur is considered, use only a standardized product clearly labeled or certified PA-free and discuss it with a clinician or pharmacist, especially when other medicines are used.
Butterbur naturally contains pyrrolizidine alkaloids that can damage the liver and may cause cancer. Only PA-free products should even be considered. Rare liver injury has occurred with products reported to be PA-free. Avoid during pregnancy or breastfeeding, and use extra caution with liver disease or allergy to ragweed-family plants.
Get medical care for symptoms that are severe, last longer than expected, get worse, or otherwise concern you.
Practical ways to use the ingredient may not provide the same form or amount discussed in the evidence.
Evidence transparency
Annals of Allergy, Asthma & Immunology
Placebo-controlled crossover trial found no significant symptom or airflow benefit, supporting low confidence.
AAAAI
Controls allergic-rhinitis diagnosis, established treatment context, allergen management, and escalation.
NCCIH
Controls PA-free requirement, liver-toxicity concerns, pregnancy/breastfeeding caution, and ragweed-family allergy risk.
Archives of Otolaryngology--Head & Neck Surgery
Randomized placebo-controlled trial reported dose-dependent symptom improvement with standardized Ze339 extract.