Is Hepatotoxic Medications Safe with Butterbur?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Avoid raw or non-PA-free butterbur products entirely. Only use certified PA-free extracts. Avoid combining with other liver-metabolized or hepatotoxic medications without physician approval. Monitor liver enzymes regularly.
Why this interaction occurs
Raw butterbur contains pyrrolizidine alkaloids (PAs), which are potent hepatotoxins. Even PA-free extracts carry theoretical hepatotoxic risk when combined with other drugs metabolized by the liver or with known hepatotoxic profiles, compounding liver stress.
Evidence
Evidence level: strong.
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 Hepatotoxic Medications interactions → · All Butterbur interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.