Butterbur
Common name
butterbur, petasites, purple butterbur
ID
HD0011
Scientific name of the plant
Petasites hybridus, Petasites officinalis, Tussilago hybrida
Anatomical part for use
root, rhizome, leaf
Human use
Urinary tract and genital disorders
Summary
Petasites is a genus of flowering plants in the sunflower family, Asteraceae, that are commonly referred to as butterburs and coltsfoots. They are perennial plants with thick, creeping underground rhizomes and large rhubarb-like leaves during the growing season. Most species are native to Asia or southern Europe. (Source: Wiki)
Evidence Level
Level 2 (Independent reports from multiple medical centers)
Hepatotoxicity reports in literature
Hepatotoxicity Description
Despite widespread use, butterbur extracts that are free of pyrrolizidine alkaloids have not been specifically linked to liver injury, either in the form of transient serum enzyme elevations or clinically apparent acute liver injury. However, because the processing of butterbur is critical to the safety of the herbal product, it has to be used with caution. After the European approval of a commercial butterbur product for use in migraine headache prevention, isolated reports of cholestatic hepatitis arose. Testing suggested that some preparations contained detectable amounts of pyrrolizidine alkaloids and some of the products were withdrawn. The relationship of the liver injury to butterbur remains controversial. A single publication summarizing clinical features of 10 cases reported to the sponsor has suggested that the liver injury was not related to the butterbur product, but 8 of the 10 cases were reasonably convincing and described a consistent clinical phenotype of fatigue, nausea and jaundice usually arising within 2 to 12 weeks of starting the product and marked by a hepatocellular pattern of injury and moderate-to-severe jaundice. Two cases resulted in urgent liver transplants, while the others apparently recovered, usually within 2 to 12 weeks. The clinical features of cases did not resemble sinusoidal obstruction syndrome and liver biopsy showed an acute hepatitis with variable degrees of cholestasis, but minimal steatosis or fibrosis and no mention of sinusoidal obstruction. Similar cases have not been described from other butterbur products. (Source: LiverTox)
Common name
butterbur, petasites, purple butterbur
ID
HD0011
Scientific name of the plant
Petasites hybridus, Petasites officinalis, Tussilago hybrida
Anatomical part for use
root, rhizome, leaf
Human use
Urinary tract and genital disorders
Summary
Petasites is a genus of flowering plants in the sunflower family, Asteraceae, that are commonly referred to as butterburs and coltsfoots. They are perennial plants with thick, creeping underground rhizomes and large rhubarb-like leaves during the growing season. Most species are native to Asia or southern Europe. (Source: Wiki)
Evidence Level
Level 2 (Independent reports from multiple medical centers)
Hepatotoxicity reports in literature
Hepatotoxicity Description
Despite widespread use, butterbur extracts that are free of pyrrolizidine alkaloids have not been specifically linked to liver injury, either in the form of transient serum enzyme elevations or clinically apparent acute liver injury. However, because the processing of butterbur is critical to the safety of the herbal product, it has to be used with caution. After the European approval of a commercial butterbur product for use in migraine headache prevention, isolated reports of cholestatic hepatitis arose. Testing suggested that some preparations contained detectable amounts of pyrrolizidine alkaloids and some of the products were withdrawn. The relationship of the liver injury to butterbur remains controversial. A single publication summarizing clinical features of 10 cases reported to the sponsor has suggested that the liver injury was not related to the butterbur product, but 8 of the 10 cases were reasonably convincing and described a consistent clinical phenotype of fatigue, nausea and jaundice usually arising within 2 to 12 weeks of starting the product and marked by a hepatocellular pattern of injury and moderate-to-severe jaundice. Two cases resulted in urgent liver transplants, while the others apparently recovered, usually within 2 to 12 weeks. The clinical features of cases did not resemble sinusoidal obstruction syndrome and liver biopsy showed an acute hepatitis with variable degrees of cholestasis, but minimal steatosis or fibrosis and no mention of sinusoidal obstruction. Similar cases have not been described from other butterbur products. (Source: LiverTox)