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{{Short description|Genus of flowering plants in the daisy family Asteraceae}}
{{Redirect|Butterbur||Butterbur (disambiguation)}}
{{Automatic taxobox
|image = Petasites hybridus inflorescence - Keila.jpg
|image_caption = ''[[Petasites hybridus]]''
|display_parents = 2
|taxon = Petasites
|authority = [[Philip Miller|Mill.]]
|synonyms =
* ''Nardosmia'' Cass.
* ''Petasitis'' Mill.
|synonyms_ref = <ref name=x>{{cite web|url=http://dixon.iplantcollaborative.org/CompositaeWeb/default.aspx?Page=NameDetails&TabNum=0&NameId=e990ca5d-1326-4a80-a702-0e12916cb02a|title=''Petasites'' Mill. |date=2009 |website=Global Compositae Checklist |editor-last=Flann |editor-first= C. |archive-url=https://archive.today/20141211233908/http://dixon.iplantcollaborative.org/CompositaeWeb/default.aspx?Page=NameDetails&TabNum=0&NameId=e990ca5d-1326-4a80-a702-0e12916cb02a |archive-date=11 December 2014 }}</ref><ref name="POWO">{{cite web |title=''Petasites'' Mill. |date=2023 |url=https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:329075-2#synonyms |work=Plants of the World Online |publisher=Royal Botanic Gardens, Kew |access-date=3 May 2023 }}</ref>
|}}
[[File:Petasites japonicus Russia.JPG|thumb|right|''[[Petasites japonicus]]'']]

'''''Petasites''''' is a genus of [[flowering plant]]s in the sunflower family, [[Asteraceae]],<ref name="WFO">{{cite web |url=http://www.worldfloraonline.org/taxon/wfo-4000028919 |title=''Petasites'' Mill. |date=2023 |website=World Flora Online |publisher=World Flora Consortium |access-date=3 May 2023}}</ref> that are commonly referred to as '''butterburs'''<ref name=Stace>{{cite book|last=Stace|first=C. A.|author-link = Stace, C. A.|year=2010|title=New Flora of the British Isles|edition=Third|publisher=Cambridge University Press|location = Cambridge, U.K.| isbn=9780521707725}}</ref><ref>Miller, Philip. 1754. Gardeners Dictionary...Abridged...fourth edition page 1056.</ref><ref>[http://www.tropicos.org/Name/40005373 Tropicos, ''Petasites'' Mill.]</ref> and '''coltsfoots'''.<ref name=fna>[http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=124686 ''Petasites''.] Flora of North America. Volume 20, Page 635. efloras.org.</ref> They are perennial plants with thick, creeping underground [[rhizome]]s and large [[rhubarb]]-like leaves during the growing season. Most species are native to Asia or southern Europe.

== Taxonomy ==
The genus name is derived from the Greek word {{lang|el|πέτασος}} ''petasos'', from the plant's broad leaves resembling a wide-brimmed hat.<ref name="drugs">{{cite web |url=https://www.drugs.com/npp/butterbur.html |title=Butterbur |date=14 February 2022 |publisher=Drugs.com |access-date=3 May 2023}}</ref>

==Species==
;Accepted species<ref name=x/><ref name="WFO"/>
* ''[[Petasites albus]]'' – white butterbur – Europe, Algeria, Turkey, [[Caucasus]], [[India]]
* ''[[Petasites fominii]]'' – [[Georgia (country)|Republic of Georgia]]
* ''[[Petasites formosanus]]'' – [[Taiwan]]
* ''[[Petasites frigidus]]'' – Arctic butterbur or Arctic sweet coltsfoot – Scandinavia, Mongolia, Canada, northern USA
* ''[[Petasites hybridus]]'' – common butterbur – Europe, Mediterranean
* ''[[Petasites japonicus]]'' – giant butterbur, fuki – China, Japan, Korea
* ''[[Petasites kablikianus]]'' – southeastern Europe from Poland to Albania
* ''[[Petasites kamengicus]]'' – [[Arunachal Pradesh]]
* ''[[Petasites paradoxus]]'' – central + southwestern Europe from Spain to Poland
* ''[[Petasites pyrenaicus]]'' syn. ''Petasites fragrans'' - winter heliotrope - from Azores to Ireland + Tunisia
* ''[[Petasites radiatus]]'' – Mongolia
* ''[[Petasites rubellus]]'' – Mongolia, Manchuria, Korea
* ''[[Petasites sibiricus]]'' – Siberia
* ''[[Petasites spurius]]'' – Europe, Siberia, Caucasus, Central Asia
* ''[[Petasites tatewakianus]]'' – Siberia, Russian Far East, northeastern China
* ''[[Petasites tricholobus]]'' – China, Vietnam, Himalayas
* ''[[Petasites versipilus]]'' – [[Sichuan]], [[Yunnan]]

;Species of hybrid origin<ref name=x/>
*''Petasites × vitifolius''

;Species formerly included<ref name=x/>
''Petasites glacialis'' (Ledeb.) Polunin - ''[[Endocellion]] glaciale'' (Ledeb.) Toman

== Characteristics ==
The short spikes of [[flower]]s are produced just before the leaves in late winter (e.g. ''[[Petasites fragrans]]''<ref name="Stace"/>) or spring, emerging with only a few elongated basal bracts and are usually green, flesh coloured or dull white depending on the species. It is [[dioecious]], with male and female flowers borne on separate plants.<ref>{{cite journal|doi=10.1080/20423489.2016.1271383|title=A new natural hybrid in the genus ''Petasites'': ''P. japonicus'' × ''P. pyrenaicus'' (Asteraceae)|year=2016|last1=Desjardins|first1=Stuart D.|last2=Hoare|first2=Arthur G.|last3=Stace|first3=Clive A.|journal=New Journal of Botany|volume=6|issue=2–3|pages=64–70|bibcode=2016NJBot...6...64D |s2cid=90843775|url=https://figshare.com/articles/journal_contribution/4668331 |url-access=subscription}}</ref>

Butterbur can be found in parts of [[Asia]] such as [[Korea]], [[China]], and [[Japan]], as well as [[Europe]] and [[North America]].<ref name="Missouri Botanical Garden">{{cite web|url=http://www.missouribotanicalgarden.org/PlantFinder/PlantFinderDetails.aspx?kempercode=a645|title=Missouri Botanical Garden}}</ref><ref name=Sun-Edelstein>{{cite journal|last1=Sun-Edelstein|first1=Christina|title=Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments|journal=Headache|date=March 2011|volume=51|issue=3|pages=469–483|doi=10.1111/j.1526-4610.2011.01846.x|pmid=21352222|s2cid=30412404|doi-access=free}}</ref> They prefer moist environments such as riverbanks, marshes and ditches.<ref name=fna/><ref name=Sutherland>{{cite journal|last1=Sutherland|first1=Anna|last2=Sweet|first2=Burgunda|title=Butterbur: An alternative therapy for migraine prevention|journal=American Journal of Health-System Pharmacy|date=May 2010|volume=67|issue=9|pages=705–711|doi=10.2146/ajhp090136|pmid=20410544}}</ref><ref>[http://www.efloras.org/florataxon.aspx?flora_id=2&taxon_id=124686 ''Petasites''.] Flora of China. Volume 20-21, Page 461. efloras.org.</ref><ref>[http://luirig.altervista.org/flora/taxa/gen.php?genere=Petasites Altervista Flora Italiana genere ''Petasites'']</ref>

''Petasites'' is closely related to the genera ''[[Tussilago]]'' and ''[[Senecio]]''.

==Medicinal uses==
Butterbur has been used for over 2000 years to treat a variety of ailments including fever, lung disease, spasms, and pain.<ref name=Sutherland /> Currently, butterbur extract is used for [[migraine]] prevention and treatment of [[allergic rhinitis]], which have the most evidence for its effectiveness.<ref name=Sutherland /><ref name="Neurology-2012" /><ref name=Kaufeler>{{cite journal|last1=Kaufeler|first1=Robert|last2=Polasek|first2=Wolfgang|last3=Brattstrom|first3=Axel|last4=Koetter|first4=Uwe|title=Efficacy and Safety of Butterbur Herbal Extract Ze 339 in Seasonal Allergic Rhinitis: Postmarketing Surveillance Study|journal=Advances in Therapy|date=March 2006|volume=23|issue=2|pages=373–384|doi=10.1007/bf02850143|pmid=16751170|s2cid=6597820}}</ref>

===Migraine===
Some butterbur species contain the chemicals [[petasin]] and [[isopetasin]] which are believed to have potential benefits in treating [[migraines]].<ref name="Sun-Edelstein" /> High concentrations of petasin occur in both butterbur root and leaves, with the leaves containing lower levels of the toxic chemical.<ref name="Taylor-2011" /> Butterbur extracts have been reported to be effective in reducing frequency and severity of [[migraine]] headaches.<ref name="Sun-Edelstein" /><ref name="Sutherland" /><ref name="Neurology-2012" /><ref name="Lipton-2004" /> Several double-blind studies have shown that high doses of ''Petasites hybridus ''extract'', ''containing petasin and/or isopetasin, are effective both in preventing and in relieving migraine, with the best results in groups taking the higher dose of the supplement.<ref name="Sun-Edelstein" /><ref name="Lipton-2004">{{cite journal |vauthors=Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A |title=Petasites hybridus root (butterbur) is an effective preventive treatment for migraine |journal=Neurology |volume=63 |issue=12 |pages=2240–4 |date=December 2004 |pmid=15623680 |doi=10.1212/01.wnl.0000147290.68260.11|s2cid=10367187 }}</ref> Although mainly well tolerated, the adverse effects of butterbur reported in clinical trials include mainly gastrointestinal problems, such as nausea, flatulence, and belching.<ref name="Facts&Comp" /><ref name="Lipton-2004" /> In 2015, the American Academy of Neurology withdrew its original endorsement of butterbur due to safety concerns.<ref name="Neurology-2012">{{Cite journal|url=https://n.neurology.org/content/78/17/1346|doi=10.1212/WNL.0b013e3182535d0c|title=Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: [RETIRED]|year=2012|last1=Holland|first1=S.|last2=Silberstein|first2=S.D.|last3=Freitag|first3=F.|last4=Dodick|first4=D.W.|last5=Argoff|first5=C.|last6=Ashman|first6=E.|journal=Neurology|volume=78|issue=17|pages=1346–1353|pmid=22529203|pmc=3335449}}</ref> However, the Canadian Headache Society still recommends its use in migraine prevention for a selected number of patients based on their clinical features and co-existing disorders.<ref>{{cite journal|last1=Pringsheim|first1=Tamara|last2=Davenport|first2=Jeptha|last3=Mackie|first3=Gordon|title=Canadian Headache Society Guideline for Migraine Prophylaxis|journal=Canadian Journal of Neurological Sciences|date=March 2012|volume=39|issue=2|pages=S1–59|pmid=22683887}}</ref>

===Hay fever or allergic rhinitis===
Additionally, a study showed butterbur extract to be an effective treatment for hay fever without the sedative effect of the antihistamine [[cetirizine]], if taken four times daily.<ref>Schapowal, A.{{cite journal |author=Schapowal A |date=19 January 2002 |title=Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis |journal=BMJ |volume=324 |issue=7330 |pages=144–6 |pmid=11799030 |doi=10.1136/bmj.324.7330.144 |url= |last2=Petasites Study |first2=Group |pmc=64514}}</ref> Butterbur was also shown to be comparably effective as [[fexofenadine]] when compared to placebo for reducing symptoms of allergic rhinitis.<ref name=Schapowal-fexofenadine>{{cite journal|last1=Schapowal|first1=Andreas|title=Treating Intermittent Allergic Rhinitis: A Prospective, Randomized, Placebo and Antihistamine-controlled Study of Butterbur Extract Ze 339|journal=Phytotherapy Research|date=2005|volume=19|pages=530–537|doi=10.1002/ptr.1705|pmid=16114089|issue=6|s2cid=38128529}}</ref>

==Risks==
Butterbur extracts may contain harmful components called [[pyrrolizidine alkaloid]]s if the preparations are not carefully and fully purified.<ref name=Sun-Edelstein /> The concentration of the toxic alkaloids is often highest in the [[rhizomes]] and lowest in the leaves, and may vary depending on where the plants are grown.<ref name="Taylor-2011">{{cite journal|last1=Taylor|first1=Frederick|title=Nutraceuticals and Headache: The Biological Basis|journal=Headache|date=March 2011|volume=51|issue=3|pages=484–501|doi=10.1111/j.1526-4610.2011.01847.x|pmid=21352223|s2cid=1828681}}</ref> These chemicals are toxic to the liver and may cause cancers.<ref>Maxim Hirono I., Mori H., Yamada K. "Carcinogenic activity of petasitenine, a new pyrrolizidine alkaloid isolated from Petasites" ''[[Journal of the National Cancer Institute]]'' 1977 58:4 (1155-1157)</ref><ref>{{cite journal | pmid = 7017073 | year = 1981 | last1 = Smith | first1 = LW | last2 = Culvenor | first2 = CC | title = Plant sources of hepatotoxic pyrrolizidine alkaloids | volume = 44 | issue = 2 | pages = 129–52 | journal = Journal of Natural Products | doi=10.1021/np50014a001}}</ref> Thus, due to the potential for contamination, taking butterbur supplements is not recommended during pregnancy or breastfeeding.<ref name=Facts&Comp>{{cite web|title=Butterbur|url=http://online.factsandcomparisons.com/MonoDisp.aspx?monoID=fandc-np5066&quick=237777%7c20&search=237777%7c20&isstemmed=True&NDCmapping=-1&fromTop=true|website=Facts & Comparisons}}</ref> Some sources say it is safe practice to consume butterbur extract that has been prepared by a reputable laboratory.<ref name=Sun-Edelstein /> Other sources say no butterbur product is safe: "The cases of liver toxicity appear to have occurred with extracts of butterbur where the [[pyrrolizidine alkaloid]]s had been removed and only small amounts remained. There is some evidence that other constituents found in butterbur such as the sesquiterpene constituents for example petasin may be implicated in the liver toxicity".<ref>{{Cite web|url=http://www.raysahelian.com/butterbur.html|title = Butterbur extract supplement benefit, allergy, asthma, and migraine headache}}</ref>{{Unreliable source?|date=April 2019}}

Long-term health effects and interaction of butterbur with other drugs have not been well documented. However, it can theoretically interact with certain blood pressure and heart medications, as well as with drugs that can induce a liver [[enzyme]] called [[CYP3A4]] (i.e. [[St. John's wort]], [[carbamazepine]], [[phenytoin]], [[rifampin]]); this interaction can potentially lead to increased concentration of the toxic alkaloids.<ref name=Facts&Comp />

== References ==
{{Reflist|30em}}

==External links==
*[http://rbg-web2.rbge.org.uk/cgi-bin/nph-readbtree.pl/feout?FAMILY_XREF=&GENUS_XREF=Petasites&SPECIES_XREF=&TAXON_NAME_XREF=&RANK= Flora Europaea: ''Petasites'' species list and distributions]
*[http://www.efloras.org/browse.aspx?flora_id=0&name_str=Petasites eFloras search results: ''Petasites'']
*[http://www.northernbushcraft.com/plants/coltsfoot/notes.htm Edibility of Petasites]: Visual identification and edible parts of sweet coltsfoot.

{{Taxonbar|from=Q830156}}
{{Authority control}}

[[Category:Asteraceae genera]]
[[Category:Medicinal plants]]
[[Category:Petasites| ]]
[[Category:Taxa named by Philip Miller]]
[[Category:Dioecious plants]]

Petasites - Revision history

imported>OAbot: Open access bot: url-access updated in citation with #oabot.