Butterbur for Migraine Prevention
The use of supplement or over the counter drugs for prevention of migraine has been controversial. However, the American Academy of Neurology and the American Headache society performed 2 high quality studies for Butterbur that have been successful. Butterbur is well tolerated having mainly GI side effects of burping and flatus. Butterbur is an herb and the the leaf, root, and bulb is used to make medicine
For preventing migraine 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.
1. Butterbur. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/butterbur. Updated September 24, 2017. Accessed July 5, 2018.
2. Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1346-1353. doi:10.1212/WNL.0b013e3182535d0c.