This is an article by Britt Talley Daniel MD, member of the American Academy of Neurology and the American Headache Society, text book author and blogger on Migraine.

What is Petadolex? Petadolex contains butterbur, a perennial shrub, found throughout Europe and in parts of Asia and North America. It is usually found in wet, marshy ground, in damp forests, and adjacent to rivers or streams. The common name is attributed to the large leaves used to wrap butter during warm weather.  It is a supplement that has been used for years for treatment of migraine.

What is the latest on Petadfolex for Migraine prevention?

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The American Academy of Neurology and the American Headache Society performed high-quality studies that led to the endorsement of the use of Petadolex as a migraine preventive drug. In short term clinical studies (16 weeks) Petadolex reduced the frequency of migraines.

1.What are the toxic liver problems with butterbur?  Some butterbur products contain liver-toxic pyrrolizidine alkaloids (PAs) and potential cancer causing chemicals. These chemicals may be removed by a special patented treatment and only marked under the name Petadolex.

Only Petadolex, which is labeled as free of PAs has been used in the research studies which established its effectiveness. 

2.What are the side effects of PAs?  PAs can damage the liver, lungs, blood circulation, and possibly cause cancer.

3.What is the dose for using Petadolex for migraine prevention? The dose is 75 mg of Petadolex twice a day for 4 months.  This was used in a clinical trial where the maximum response was achieved after 3 months with a migraine attack reduction of 58%. 

4.Have there been successful controlled trials demonstrating migraine prevention with Petadolex? Two randomized, placebo-controlled migraine prevention trials with a total of 289 patients demonstrated the short-term safety and efficacy of the butterbur root extract in adults.

The first study was published in Neurology. 2012;78(17):1346-1353 by Holland, et al.  The second study may be found at Butterbur. National Center for Complementary and Integrative health.  https://nccih.nih.gov/health/butterbur.

What are the side effects of Petadolex when used for migraine prevention?  Petadolex is generally tolerated well, but it can cause belching, headache, itchy eyes, diarrhea, asthma, upset stomach, fatigue, and drowsiness.  Persons who are allergic to ragweed, marigolds, and daisies may get an allergic reaction from Butterbur.

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1.Is Butterbur used for anything else in medicine?  As a supplement, available over the counter, Butterbur was used for pain, upset stomach, stomach ulcers, ongoing cough, chills, anxiety, plague, fever, insomnia (insomnia), hay fever, irritable bladder, urinary tract spasms, and to stimulate the appetite.

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Britt Talley Daniel MD