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Dietary supplement

Butterbur Ingredients & Drug Interactions

by NOW

Butterbur label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Butterbur against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Butterbur is a dietary supplement by NOW with 2 active ingredients. Its ingredients are commonly taken for migraine prevention, headache, fever (traditional).Based on those ingredients, 974 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Feverfew, Butterbur Root Extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Butterbur by NOW

Ask about any prescription or over-the-counter medication and we check it for interactions with Butterbur by NOW — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Butterbur by NOW

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 2 of its 2 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This product contains two active ingredients: feverfew and butterbur root extract. Feverfew is a plant traditionally used for headaches and inflammation.

Butterbur root extract comes from a plant studied for migraine prevention and seasonal allergies. The remaining ingredients — hypromellose, microcystalline cellulose, maltodextrin, potato starch, stearic acid, and silicon dioxide — are inactive components that help form and stabilize the capsule.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Neurological support and healthy brain blood flow.
  • We looked for evidence on: Migraine headache, Tension headache, Cerebral blood flow, Brain health.
  • The strongest evidence on file: Butterbur is rated "Possibly Effective" for Migraine headache (Natural Medicines).
  • Also on file: Feverfew is rated "Insufficient Reliable Evidence To Rate" for Tension headache.

The evidence for feverfew in tension headaches is insufficient to rate its effectiveness. Butterbur root extract, on the other hand, is rated as possibly effective for migraine headache prevention and for allergic rhinitis (hay fever).

This means some studies suggest benefit, but the evidence isn't conclusive yet.

The evidence, ingredient by ingredient Feverfew Butterbur

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 2 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Both ingredients are generally well tolerated, though feverfew can cause mouth irritation (especially if you chew the fresh leaves), gastrointestinal upset — including nausea, heartburn, diarrhea, bloating, and abdominal pain — and, rarely, skin rash. Butterbur may cause belching, diarrhea, drowsiness, fatigue, headache, itchy eyes, rash, and stomach upset.

One important caution: this product must contain only PA-free (pyrrolizidine alkaloid-free) butterbur, because raw butterbur can damage your liver. Stopping feverfew after long-term use may briefly trigger anxiety, headaches, or insomnia.

Neither ingredient should be used in pregnancy or while breastfeeding — feverfew is possibly unsafe in pregnancy and may stimulate the uterus, while butterbur is likely unsafe for both pregnancy and lactation due to insufficient safety data and potential liver risks.

Side effects, ingredient by ingredient Feverfew Butterbur

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Butterbur, Feverfew.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs.
  • For scale: 975 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check your list of medications against these drug types: blood thinners and antiplatelet drugs (because of feverfew's potential to increase bleeding risk), and any drugs metabolized by liver enzymes CYP2C19, CYP2D6, CYP1A2, CYP2C9, CYP2C8, or CYP3A4, since feverfew may theoretically raise their levels. Use the medication interaction checker on this page with your exact prescriptions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

NOW Butterbur is worth considering if you're looking for natural support for migraines or seasonal allergies, and the active ingredients are generally well tolerated. If you take any blood thinners, antiplatelet drugs, or prescription medications that are cleared by your liver, check with us or your pharmacist before starting.

Avoid it if you're pregnant or breastfeeding.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 2 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2025.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Butterbur, straight from the product label.

Brand NOW
Barcode (UPC) 733739046024
Net contents 60 Veg Capsule(s)
Market status On market
Date entered into DSLD Sep 25, 2025
DSLD ID 335213
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, Women (not pregnant or lactating), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Butterbur by NOW, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Veg Capsule(s)
Maximum serving Sizes:
1 Veg Capsule(s)
Servings per container
60
UPC/BARCODE
733739046024
IngredientAmount% DV
Feverfew200 mg--
Butterbur Root Extract75 mg--

Other ingredients: Hypromellose, Microcystalline Cellulose, Maltodextrin, Potato Starch, Stearic Acid, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Suggested usage: Take 1 capsule twice daily.

Formula

European herbalists have been using butterbur for decades and scientific studies have demonstrated that petasins, the active constituents in butterbur, can support healthy blood flow to the brain and promote normal neurological function. In this way, butterbur may help to maintain head comfort in healthy individuals.

Butterbur with feverfew

Triangle K (Kosher)

Formulation

NOW Butterbur is also free of undesirable pyrrolizidine alkaloids (PA’s), so it can be used regularly.

Natural color variation may occur in this product. Neurological support Supports healthy blood flow to the brain

Non-GMO

Vegetarian/Vegan

Made and quality tested in the USA with globally sourced ingredients.

Not manufactured with wheat, gluten, soy, milk, egg, fish, shellfish, tree nut or sesame ingredients.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Precautions

Caution: For adults only. Keep out of reach of children.

Not recommended for pregnant/nursing women or individuals with liver disease. Consult physician if taking medication or have a medical condition.

Not manufactured with wheat, gluten, soy, milk, egg, fish, shellfish, tree nut or sesame ingredients. Produced in a GMP facility that processes other ingredients containing these allergens.

FDA Statement of Identity

A Dietary Supplement

Seals/Symbols

Triangle K (Kosher)

GMP Quality Assured

General Statements

This bottle is made from 100% PCR (post-consumer recycled) resin. Botanicals/Herbs Family owned since 1968.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Butterbur by NOW label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Butterbur label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Butterbur by NOW

These are the 2 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Veg Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Feverfew

Interacts with
929 drugs
200 mg per serving

Feverfew is a daisy-family herb best known for migraine prevention, where some studies suggest it may modestly lower how often migraines occur, though...

Feverfew monograph & interactions

Butterbur Root Extract

Interacts with
87 drugs
75 mg per serving

Butterbur is a plant extract most studied for preventing migraines and easing hay fever symptoms, and some standardized products show promise. However...

Butterbur Root Extract monograph & interactions

Other (inactive) ingredients: Hypromellose, Microcystalline Cellulose, Maltodextrin, Potato Starch, Stearic Acid, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Butterbur by NOW Drug Interactions

Want to check YOUR meds against Butterbur?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
974Drugs
974 Moderate

Ingredients driving the most interactions

Feverfew 929
Butterbur Root Extract 87

Individual Drug Interactions

The ingredients in Butterbur interact with 974 drugs. Click any drug to see the details.

2 of the 2 ingredients in Butterbur interact with drugs. Each result below shows which ingredient is responsible. Feverfew Butterbur Root Extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Butterbur with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Feverfew7 drug types · 929 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, feverfew might have additive effects and increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Laboratory research suggests that feverfew may inhibit platelet aggregation. Additionally, in one case report, a 36-year-old patient taking feverfew 2400 mg daily for 3 months experienced vaginal bleeding and a prolonged menstrual cycle, with a modest increase in partial thromboplastin time (PTT) and prothrombin time (PT).

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Laboratory research shows that feverfew might inhibit CYP1A2. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.
Laboratory research shows that feverfew might inhibit CYP2C19. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C8.
Laboratory research shows that feverfew might inhibit CYP2C8. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, feverfew might increase levels of drugs metabolized by CYP2C9.
Laboratory research shows that feverfew might inhibit CYP2C9. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Laboratory research shows that feverfew might inhibit CYP2D6. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that feverfew might inhibit CYP3A4. So far, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Feverfew full monograph & interactions

Butterbur Root Extract1 drug type · 87 drugs

Cytochrome P450 3A4 (Cyp3A4) Inducers

Theoretically, CYP3A4 inducers might increase the toxicity of butterbur.
The pyrrolizidine alkaloid (PA) constituents found in some butterbur products are substrates of CYP3A4. Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites.

Likelihood Possible Evidence D
Butterbur Root Extract full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Butterbur, from the product label.

NOW

See all NOW products
Name
NOW FOODS
Street Address
395 S. Glen Ellyn Rd.
City
Bloomingdale
State
IL
ZipCode
60108
Web Address
nowfoods.com
Pharmacist Counseling Corner

Butterbur by NOW: Common Questions

Does Butterbur by NOW interact with any medications?
Yes. Based on its ingredients, Butterbur has a known interaction with 974 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Butterbur contains 2 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this work for migraines?
Butterbur root extract in this product is rated possibly effective for migraine headache — some research supports it, though more evidence is needed. Feverfew's effectiveness for tension headaches isn't yet established in the data we hold.
What are the most common side effects?
Feverfew often causes stomach upset — nausea, heartburn, diarrhea, bloating, and abdominal pain — plus occasional mouth irritation. Butterbur may cause belching, diarrhea, drowsiness, fatigue, headache, itchy eyes, and rash. These are usually mild.
Can I take this while pregnant or nursing?
No. Feverfew is possibly unsafe in pregnancy because it may stimulate the uterus, and butterbur is likely unsafe for both pregnancy and breastfeeding due to liver and other safety concerns. Talk to your doctor or pharmacist for personalized advice if you're expecting or nursing.
Will this hurt my liver?
This product must contain only PA-free butterbur (free of pyrrolizidine alkaloids) to be safe — raw butterbur can cause liver damage. Assuming it's PA-free as labeled, liver injury is rare, though a small number of cases have been reported even with PA-free products. If you have liver disease, check with your pharmacist first.
What happens if I stop taking this after a while?
Stopping feverfew after long-term use may briefly trigger "post-feverfew syndrome," which includes anxiety, headaches, and insomnia. It usually resolves on its own.
Can I chew the feverfew leaves fresh instead of taking the capsule?
The facts don't cover that option, but we know chewing fresh feverfew leaves is more likely to cause mouth ulceration and other mouth and tongue problems compared to processed capsule products. Ask your pharmacist if you're interested in other forms.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Butterbur label
Go deeper

The Full Monographs Behind Butterbur’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Feverfew

Interacts with 929 drugs

Feverfew is a daisy-family herb best known for migraine prevention, where some studies suggest it may modestly lower how often migraines occur, though the evidence is mixed. It is generally...

Read the full Feverfew monograph → Herb & supplement monograph

Butterbur

Interacts with 87 drugs

Butterbur is a plant extract most studied for preventing migraines and easing hay fever symptoms, and some standardized products show promise. However, raw or unprocessed butterbur contains...

Read the full Butterbur monograph →
Sources

Sources & How We Checked

Butterbur's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 25 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Feverfew 18 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Awang DVC. Prescribing therapeutic feverfew (Tancetum pathrnium (L.) Schultz Bip., syn. Chrysanthemumparthenium (L.) Bernh). Int Med 1998;1:11-3.
  3. Heptinstall S, Groenewegen WA, Spangenberg P, Loesche W. Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. J Pharm Pharmacol 1987;39:459-65. PubMed
  4. Heptinstall S, White A, Williamson L, Mitchell JR. Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet 1985;1:1071-4. PubMed
  5. Makheja AN, Bailey JM. A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Prostaglandins Leukot Med 1982;8:653-60.
  6. Groenewegen WA, Heptinstall S. A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. J Pharm Pharmacol 1990;42:553-7. PubMed
  7. Heptinstall S, Groenewegen WA, Spangenberg P, Losche W. Inhibition of platelet behaviour by feverfew: a mechanism of action involving sulphydryl groups. Folia Haematol Int Mag Klin Morphol Blutforsch 1988;115:447-9.
  8. Biggs MJ, Johnson ES, Persaud NP, Ratcliffe DM. Platelet aggregation in patients using feverfew for migraine. Lancet 1982;2:776. PubMed
  9. Lamminpaa A, Estlander T, Jolanki R, Kanerva L. Occupational allergic contact dermatitis caused by decorative plants. Contact Dermatitis 1996;34:330-5. PubMed
  10. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed) 1985;291:569-73. PubMed
  11. Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database Syst Rev 2004;(1):CD002286. PubMed
  12. Ernst E, Pittler MH. The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Public Health Nutr 2000;3:509-14.
  13. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  14. Sil'vestrov VP, Kinitin AV, and Chesnokova, IV. [Immunological and metabolic disorders and the means for their correction in patients with chronic bronchitis]. Ter.Arkh. 1991;63:7-11.
  15. Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078-86.
  16. Jovanovic, M. and Poljacki, M. [Compositae dermatitis]. Med Pregl. 2003;56(1-2):43-49. PubMed
  17. Burry, J. N. Compositae dermatitis in South Australia: contact dermatitis from Chrysanthemum parthenium. Contact Dermatitis 1980;6(6):445.
  18. Alenzi KA, Alharbi FH, Tawhari FM, Fradees GS. Alteration of Coagulation Test Results and Vaginal Bleeding Associated With the Use of Feverfew (Tanacetum parthenium). J Med Cases 2021;12(1):9-12.

See these in context on the Feverfew monograph →

Butterbur 7 references
  1. Danesch U, Rittinghausen R. Safety of a patented special butterbur root extract for migraine prevention. Headache 2003;43:76-8.. PubMed
  2. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  3. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
  4. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
  5. Pothmann R, Danesch U. Migraine Prevention in Children and Adolescents: Results of an Open Study With a Special Butterbur Root Extract. Headache 2005;45:196-203.. PubMed
  6. Oelkers-Ax R, Leins A, Parzer P, et al. Butterbur root extract and music therapy in the prevention of childhood migraine: an explorative study. Eur J Pain 2008;12:301-13. PubMed
  7. Schapowal A. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Arch Otolaryngol.Head Neck Surg. 2004;130:1381-86. PubMed

See these in context on the Butterbur monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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