Is Diphenhydramine Safe with Butterbur?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid combining butterbur with diphenhydramine, especially in elderly patients or those operating heavy machinery. If use is necessary, start with the lowest doses and monitor for excessive drowsiness.
Why this interaction occurs
Butterbur has mild anticholinergic and CNS-depressant properties. Combined with diphenhydramine, a first-generation antihistamine with significant CNS and anticholinergic activity, additive effects may increase risk of confusion, urinary retention, dry mouth, and falls.
Evidence
Evidence level: limited.
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 59 reports mentioning Butterbur. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Butterbur + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Diphenhydramine interactions → · All Butterbur interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.