Plant Comparison

Ivy Leaf vs Butterbur

A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.

First plant
Second plant
Show:
Plant AIvy LeafHedera helixAraliaceaeFull monograph →
Plant BButterburPetasites hybridusAsteraceaeFull monograph →

At a glance

Ivy Leaf and Butterbur: they share 4 indicated uses (asthma, cough, menstrual cramps, …); 2 pharmacological actions in common.

Ivy LeafButterbur
Constituents22
Pharmacological actions34
Indicated uses69
Safety notes22
Cited sources1414
Indicated uses
Only Ivy Leaf
BronchitisRespiratory support
Shared (4)
AsthmaCoughMenstrual crampsMuscle spasm
Only Butterbur
Allergy / hay feverCancer (anticancer research)FeverHeadacheMigraine
Pharmacological actions
Only Ivy Leaf
Expectorant
Shared (2)
AntispasmodicBronchodilator / anti-asthmatic
Only Butterbur
Anticancer (preclinical)Antihistaminic / antiallergic

Evidence face-off — shared uses

ConditionIvy LeafButterburVerdict
Asthma3/103/10Comparable evidence
Cough7/102/10Stronger for Ivy Leaf
Menstrual cramps3/102/10Comparable evidence
Muscle spasm3/102/10Comparable evidence

Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.

Key Constituents

Triterpene saponins (hederacoside C, alpha-hederin)[4, 5, 7, 8, 12, 13]

The secretolytic and antispasmodic active constituents; extracts are standardised to them.

Triterpene saponinsTerpenes / terpenoidsSaponins
Flavonoids and phenolic acids[12]

Antioxidant supporting constituents.

Phenolic acidsFlavonoids
Sesquiterpenes (petasin and isopetasin)[2, 5, 7, 9, 10, 11]

The anti-inflammatory and antispasmodic active principles; standardised in commercial extracts.

Sesquiterpenes
Pyrrolizidine alkaloids (PAs)[11]

Naturally present but hepatotoxic and carcinogenic; must be removed to make a safe product.

Alkaloids

Pharmacological Actions

Antispasmodic[5, 7, 10, 12]

Antispasmodic / bronchodilatory - eases coughing fits and breathlessness

Bronchodilator / anti-asthmatic[5, 12]

Antispasmodic / bronchodilatory - eases coughing fits and breathlessness

Expectorant[1, 2, 3, 12, 13, 14]

Expectorant / secretolytic for productive cough and acute bronchitis (loosens and helps clear mucus)

Anticancer (preclinical)[5]
Antihistaminic / antiallergic[2, 3, 8, 11, 12]

Relief of allergic rhinitis / hay fever (antihistaminic and leukotriene-inhibiting; systematic review found it superior to placebo and comparable to non-sedating antihistamines for intermittent allergic rhinitis)

Antispasmodic[2, 6, 8, 9, 11]

Antispasmodic support in bronchial asthma

Bronchodilator / anti-asthmatic[6, 11]

Antispasmodic support in bronchial asthma

Traditional & Indicated Uses

Asthma[12]Limited · 3/10

inferred from bronchodilator action

Evidence: 3
Label: Asthma
Bronchitis[12, 13, 14]Good · 7/10

Expectorant / secretolytic for productive cough and acute bronchitis (loosens and helps clear mucus)

Evidence: 7
Label: Bronchitis
Cough[12, 13, 14]Good · 7/10

Expectorant / secretolytic for productive cough and acute bronchitis (loosens and helps clear mucus)

Evidence: 7
Label: Cough
Menstrual cramps[12]Limited · 3/10

inferred from antispasmodic action

Evidence: 3
Label: Menstrual cramps
Muscle spasm[12]Limited · 3/10

inferred from antispasmodic action

Evidence: 3
Label: Muscle spasm
Respiratory support[12, 13, 14]Good · 7/10

inferred from expectorant action

Evidence: 7
Label: Respiratory support
Allergy / hay fever[3, 11, 12]Good · 8/10

Relief of allergic rhinitis / hay fever (antihistaminic and leukotriene-inhibiting; systematic review found it superior to placebo and comparable to non-sedating antihistamines for intermittent allergic rhinitis)

Evidence: 8
Label: Allergy / hay fever
Asthma[6, 11]Limited · 3/10

Antispasmodic support in bronchial asthma

Evidence: 3
Label: Asthma
Cancer (anticancer research)[5]Traditional · 2/10

inferred from anticancer action

Evidence: 2
Label: Cancer (anticancer research)
Cough[11]Traditional · 2/10

inferred from bronchodilator action

Evidence: 2
Label: Cough
Fever[11, 12]Good · 7/10

Relief of allergic rhinitis / hay fever (antihistaminic and leukotriene-inhibiting; systematic review found it superior to placebo and comparable to non-sedating antihistamines for intermittent allergic rhinitis)

Evidence: 7
Label: Fever
Headache[4, 11, 13]Moderate · 6/10
Evidence: 6
Label: Headache
Menstrual cramps[11]Traditional · 2/10

inferred from antispasmodic action

Evidence: 2
Label: Menstrual cramps
Migraine[4, 11, 13]Moderate · 6/10

Migraine prophylaxis (reduces attack frequency; up to ~60% reduction vs placebo in a randomised controlled trial of a standardised CO2 root extract)

Evidence: 6
Label: Migraine
Muscle spasm[11]Traditional · 2/10

inferred from antispasmodic action

Evidence: 2
Label: Muscle spasm

Safety, Cautions & Contraindications

Safety note[12]Info

Generally well tolerated; occasional gastrointestinal upset or, rarely, allergic reaction. Use only standardised extract products - the fresh raw plant contains irritant saponins and falcarinol that can cause contact dermatitis.

Safety note[12]Caution

A cough lasting more than a week, or with fever, breathlessness or purulent sputum, needs medical assessment. Safety in pregnancy and breastfeeding is not established.

Safety note[11]Serious

Use ONLY certified pyrrolizidine-alkaloid (PA)-free, standardised extracts. Raw or unprocessed butterbur contains PAs that are toxic to the liver and potentially carcinogenic.

Safety note[11]Caution

Avoid during pregnancy and breastfeeding. As a member of the daisy family (Asteraceae), it can cause allergic reactions in people sensitive to ragweed and related plants. Watch for and report any signs of liver problems.

External Ids

Gbif: 8351737
Wikidata: Q26354
Gbif: 9490132
Wikidata: Q375620

Botanical Description

Woody, evergreen climbing or trailing vine that attaches to surfaces by small aerial rootlets. Juvenile leaves are glossy, dark green with three to five lobes; mature, flowering growth on well-lit stems produces unlobed, oval leaves. Small, greenish-yellow flowers in rounded umbels appear in autumn on mature growth, followed by black berries.[12]

Height: Climbing/trailing to 20-30 m where supported
Habit: Woody, evergreen climbing or trailing vine
Leaves: Juvenile leaves glossy, three- to five-lobed; mature leaves unlobed, oval
Flowers: Small, greenish-yellow, in rounded umbels, on mature flowering growth
Stem: Woody, climbing by small aerial rootlets
Root: Woody root system plus climbing aerial rootlets
Fruit: Black berry (toxic if eaten in quantity - not used medicinally)
Flowering Period: Autumn (on mature growth only)

Robust, rhizomatous perennial herb (Asteraceae) that flowers before the leaves emerge: thick, pinkish, scaly flower spikes push up from the ground in early spring, followed by enormous rounded to heart-shaped leaves - up to about 1 m across at maturity - on stout stalks, giving rise to the common name 'umbrella plant'.[2]

Height: Flower spikes low in early spring; leaves later up to ~1 m across
Habit: Robust, rhizomatous, colony-forming perennial herb
Leaves: Enormous, rounded to heart-shaped, up to ~1 m across, on stout stalks
Flowers: Thick, pinkish, scaly flower spikes, appearing before the leaves
Stem: Thick underground rhizome; scaly flowering stalks in early spring
Root: Thick, spreading rhizome
Fruit: Small ribbed achenes with a pappus (typical Asteraceae)
Flowering Period: February-April, before the leaves emerge

Habitat

Grows as a climbing or ground-covering evergreen on trees, walls, buildings and woodland floors, tolerant of shade; native to Europe and Western Asia and widely naturalised elsewhere.

Native to damp, marshy ground across Europe and western Asia - riverbanks, ditches, wet meadows and damp woodland margins - favouring moist, nutrient-rich soils.[2]

Harvesting

Juvenile (lobed) leaves are picked for medicinal use, typically in spring to summer, then dried and processed into standardised extract; the fresh raw leaf is not used directly due to irritant saponins.

Parts: Leaf (standardised dry extract)

Rhizome/root is dug in autumn or early spring; leaves are gathered during the growing season. Raw material naturally contains hepatotoxic pyrrolizidine alkaloids, so commercial products are manufactured to remove them (PA-free standardised extracts); home-gathered material should never be used medicinally.[11]

Parts: Root/rhizome, Leaf
Season: Root/rhizome in autumn or early spring; leaf during the growing season

Traditional Uses

Ivy leaf has a long European folk history as an expectorant remedy for coughs and chest complaints, and modern standardised leaf extracts are among the best-studied herbal treatments for acute bronchitis and productive cough, shown in clinical trials to reduce cough severity and ease breathing.[12]

Butterbur has a long European folk-medicine history as a fever remedy - the name 'pestilence wort' reflects its historic use during plague outbreaks - and for asthma, cough and migraine-type headache. Modern clinical trials of standardised, pyrrolizidine-alkaloid-free extracts support its use for migraine prevention and allergic rhinitis.[2, 3, 4]

Preparations

Standardised dry extract (syrup/drops)[12]

Leaf extract standardised to saponin (hederacoside C) content, formulated as a cough syrup or drops; the well-studied clinical form for acute bronchitis and productive cough.

Standardised PA-free extract (tablet)[3, 4, 11]

The only recommended form - e.g. the CO2-extracted root product studied for migraine prevention, or the Ze 339 leaf extract studied for allergic rhinitis. Raw root or leaf tea should never be used, as it retains hepatotoxic pyrrolizidine alkaloids.

Dosage

Standardised extract (syrup)[12]

Commercial standardised ivy-leaf syrups are typically dosed per product labelling (varying by age); clinical trials show benefit within about 48 hours of starting treatment. Educational reference only, not a prescription.

Standardised PA-free extract[3, 4]

Clinical trials have used standardised PA-free extracts (for example around 50-75 mg twice daily of a CO2 root extract for migraine prevention). Always use a certified PA-free commercial product, never raw plant material. Educational reference only, not a prescription.

References

REF-0833, REF-0834, REF-0835, REF-2308, REF-2309, REF-2310, REF-2311, REF-2312, REF-2313, REF-2314, REF-2315
REF-1476, REF-1477, REF-1478, REF-1479, REF-1480, REF-1481, REF-1482, REF-1483, REF-1484, REF-1485

Lookalikes Review

Outcome: none-known
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07
Outcome: has-lookalikes
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07

Dangerous Lookalikes

Not documented

Safety note[14]Dangerous
Dangerous Plant: adenostyles-alliariae
Confused Part: Very large rounded leaves and rhizome gathered for use; alpendost has similar large rounded leaves and the same hepatotoxic pyrrolizidine alkaloids.
Confusion Context: Butterbur (Petasites hybridus) has very large rounded leaves and is used medicinally (as pyrrolizidine-free standardised extracts). In the wild its foliage is confused with alpendost (Adenostyles alliariae) and coltsfoot, all large-leaved damp-ground plants. Alpendost contains hepatotoxic pyrrolizidine alkaloids and, gathered in mistake for coltsfoot/butterbur and brewed as tea, has caused liver veno-occlusive disease (Sperl et al., 1995). Butterbur's own raw leaves also contain pyrrolizidine alkaloids, so wild butterbur should only be used as tested, PA-free products rather than home-gathered material.
Distinguishing Features: Leaf: butterbur has enormous rounded leaves (up to about 1 m across when mature) on stout stalks; alpendost leaves are large but smaller and more coarsely toothed. Neither should be brewed from home-gathered material., Flowers: butterbur pushes up thick pinkish flower spikes in early spring before the leaves; alpendost has fluffy whitish-pink flower clusters among its leaves in summer., Best practice: do not brew wild butterbur or its large-leaved lookalikes at all - use only standardised, pyrrolizidine-free commercial butterbur preparations.
Key Test: Do not gather large rounded 'butterbur' leaves for tea - butterbur, alpendost and coltsfoot all look alike and carry liver-damaging pyrrolizidine alkaloids. Use only standardised, pyrrolizidine-free commercial butterbur products rather than home-collected leaves.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07

References & Sources

  1. Sierocinski, E., Holzinger, F. and Chenot, J.F (2021) 'Ivy leaf (Hedera helix) for acute upper respiratory tract infections: an updated systematic review', European Journal of Clinical Pharmacology, 77(8), pp. 1113-1122. doi:10.1007/s00228-021-03090-4 Meta-analysis / review
    https://doi.org/10.1007/s00228-021-03090-4
  2. Baharara, H., Moghadam, A.T., Sahebkar, A., Emami, S.A. et al (2021) 'The Effects of Ivy (Hedera helix) on Respiratory Problems and Cough in Humans: A Review', Advances in Experimental Medicine and Biology, 1328, pp. 361-376. doi:10.1007/978-3-030-73234-9_23 Traditional / reference
    https://doi.org/10.1007/978-3-030-73234-9_23
  3. Song, K.J., Shin, Y.J., Lee, K.R., Lee, E.J. et al (2015) 'Expectorant and antitussive effect of Hedera helix and Rhizoma coptidis extracts mixture', Yonsei Medical Journal, 56(3), pp. 819-824. doi:10.3349/ymj.2015.56.3.819 Preclinical
    https://doi.org/10.3349/ymj.2015.56.3.819
  4. Yu, M., Liu, J., Li, L., Xu, H., Xing, Y., Zhao, Y. and Yu, Z (2016) 'Pharmacokinetic parameters of three active ingredients hederacoside C, hederacoside D, and alpha-hederin in Hedera helix in rats', Journal of Separation Science, 39(17), pp. 3292-3301. doi:10.1002/jssc.201600523 Preclinical
    https://doi.org/10.1002/jssc.201600523
  5. Sieben, A., Prenner, L., Sorkalla, T., Wolf, A., Jakobs, D., Runkel, F. and Haberlein, H (2009) 'Alpha-hederin, but not hederacoside C and hederagenin from Hedera helix, affects the binding behavior, dynamics, and regulation of beta-2-adrenergic receptors', Biochemistry, 48(15), pp. 3477-3482. doi:10.1021/bi802036b Preclinical
    https://doi.org/10.1021/bi802036b
  6. Alkattan, A., Alameer, R., Alsalameen, E., Almaary, M., Alkhairat, M., Alkhalifah, A., Alghanim, F. and Radwan, N (2021) 'Safety of English ivy (Hedera helix) leaf extract during pregnancy: retrospective cohort study', DARU Journal of Pharmaceutical Sciences, 29(2), pp. 493-499. doi:10.1007/s40199-021-00415-7 Clinical study
    https://doi.org/10.1007/s40199-021-00415-7
  7. Trute, A., Gross, J., Mutschler, E. and Nahrstedt, A (1997) 'In vitro antispasmodic compounds of the dry extract obtained from Hedera helix', Planta Medica, 63(2), pp. 125-129. doi:10.1055/s-2006-957627 Preclinical
    https://doi.org/10.1055/s-2006-957627
  8. Gavrila, A.I., Tatia, R., Seciu-Grama, A., Tarcomnicu, I., Negrea, C., Calinescu, I., Zalaru, C., Moldovan, L., Raiciu, A.D. and Popa, I (2022) 'Ultrasound assisted extraction of saponins from Hedera helix L. and an in vitro biocompatibility evaluation of the extracts', Pharmaceuticals, 15(10), pp. 1197. doi:10.3390/ph15101197 Preclinical
    https://doi.org/10.3390/ph15101197
  9. Suleyman, H., Mshvildadze, V., Gepdiremen, A. and Elias, R (2003) 'Acute and chronic antiinflammatory profile of the ivy plant, Hedera helix, in rats', Phytomedicine, 10(5), pp. 370-374. doi:10.1078/0944-7113-00260 Preclinical
    https://doi.org/10.1078/0944-7113-00260
  10. Mendel, M., Chlopecka, M., Dziekan, N. and Wiechetek, M (2011) 'The effect of the whole extract of common ivy (Hedera helix) leaves and selected active substances on the motoric activity of rat isolated stomach strips', Journal of Ethnopharmacology, 134(3), pp. 796-802. doi:10.1016/j.jep.2011.01.036 Preclinical
    https://doi.org/10.1016/j.jep.2011.01.036
  11. Rosca-Casian, O., Mircea, C., Vlase, L., Gheldiu, A., Teuca, D.T. and Parvu, M (2017) 'Chemical composition and antifungal activity of Hedera helix leaf ethanolic extract', Acta Biologica Hungarica, 68(2), pp. 196-207. doi:10.1556/018.68.2017.2.7 Preclinical
    https://doi.org/10.1556/018.68.2017.2.7
  12. Kruttschnitt, E., Wegener, T., Zahner, C. and Henzen-Bucking, S (2020) 'Assessment of the Efficacy and Safety of Ivy Leaf Cough Syrup Compared with Acetylcysteine in Adults and Children with Acute Bronchitis', Evidence-Based Complementary and Alternative Medicine. doi:10.1155/2020/1910656 Clinical study
    https://doi.org/10.1155/2020/1910656
  13. Schonknecht, K., Fal, A.M., Mastalerz-Migas, A., Joachimiak, M. and Doniec, Z (2017) 'Efficacy of dry extract of ivy leaves in the treatment of productive cough', Wiadomosci Lekarskie. Randomized trial
    https://scholar.google.com/scholar?q=Efficacy%20of%20dry%20extract%20of%20ivy%20leaves%20in%20the%20treatment%20of%20productive%20cough
  14. Schaefer, A., Kehr, M.S., Giannetti, B.M., Bulitta, M. and Staiger, C (2016) 'A randomized, controlled, double-blind, multi-center trial to evaluate the efficacy and safety of a liquid containing ivy leaves dry extract (EA 575) vs. placebo in the treatment of adults with acute cough', Die Pharmazie, 71(9), pp. 504--509. doi:10.1691/ph.2016.6712 Randomized trial
    https://doi.org/10.1691/ph.2016.6712
  1. Alhusayan, R.M., Aldahmash, B.A., El-Nagar, D.M., Rady, A. and others (2020) 'Butterbur (Petasites hybridus) Extract Ameliorates Hepatic Damage Induced by Ovalbumin in Mice', Oxidative Medicine and Cellular Longevity, 2020, pp. 3178214. doi:10.1155/2020/3178214 Preclinical
    https://doi.org/10.1155/2020/3178214
  2. Kalin, P (2003) 'The common butterbur (Petasites hybridus)--portrait of a medicinal herb', Forschende Komplementarmedizin und Klassische Naturheilkunde, 10(Suppl 1), pp. 41-44. doi:10.1159/000071691 Meta-analysis / review
    https://doi.org/10.1159/000071691
  3. Brattstrom, A (2003) 'A newly developed extract (Ze 339) from butterbur (Petasites hybridus L.) is clinically efficient in allergic rhinitis (hay fever)', Phytomedicine, 10(Suppl 4), pp. 50-52. doi:10.1078/1433-187x-00304 Meta-analysis / review
    https://doi.org/10.1078/1433-187x-00304
  4. Lipton, R.B., Gobel, H., Einhaupl, K.M., Wilks, K. and Mauskop, A (2004) 'Petasites hybridus root (butterbur) is an effective preventive treatment for migraine', Neurology, 63(12), pp. 2240-2244. doi:10.1212/01.wnl.0000147290.68260.11 Randomized trial
    https://doi.org/10.1212/01.wnl.0000147290.68260.11
  5. Apostolova, S., Oreshkova, T., Uzunova, V., Georgieva, I. and others (2023) 'A Standardized Extract of Petasites hybridus L., Containing the Active Ingredients Petasins, Acts as a Pro-Oxidant and Triggers Apoptosis through Elevating of NF-kB in a Highly Invasive Human Breast Cancer Cell Line', Frontiers in Bioscience (Landmark Edition), 28(6), pp. 111. doi:10.31083/j.fbl2806111 Preclinical
    https://doi.org/10.31083/j.fbl2806111
  6. Danesch, U.C (2004) 'Petasites hybridus (Butterbur root) extract in the treatment of asthma--an open trial', Alternative Medicine Review, 9(1), pp. 54-62. Clinical study
    https://scholar.google.com/scholar?q=Petasites%20hybridus%20%28Butterbur%20root%29%20extract%20in%20the%20treatment%20of%20asthma--an%20open%20trial
  7. Aydin, A.A., Zerbes, V., Parlar, H. and Letzel, T (2013) 'The medical plant butterbur (Petasites): analytical and physiological (re)view', Journal of Pharmaceutical and Biomedical Analysis, 75, pp. 220-229. doi:10.1016/j.jpba.2012.11.028 Meta-analysis / review
    https://doi.org/10.1016/j.jpba.2012.11.028
  8. Kulinowski, L., Luca, S.V., Minceva, M. and Skalicka-Wozniak, K (2022) 'A review on the ethnobotany, phytochemistry, pharmacology and toxicology of butterbur species (Petasites L.)', Journal of Ethnopharmacology, 293, pp. 115263. doi:10.1016/j.jep.2022.115263 Meta-analysis / review
    https://doi.org/10.1016/j.jep.2022.115263
  9. Alternative Medicine Review (2001) 'Monograph: Petasites hybridus', Alternative Medicine Review, 6(2), pp. 207-209. Meta-analysis / review
    https://scholar.google.com/scholar?q=Monograph%3A%20Petasites%20hybridus
  10. Kulinowski, L., Luca, S.V., Pecio, L., Minceva, M. and Skalicka-Wozniak, K (2023) 'Liquid-liquid chromatography isolation of Petasites hybridus sesquiterpenes and their LC-HR-MS/MS and NMR characterization', Journal of Pharmaceutical and Biomedical Analysis, 234, pp. 115529. doi:10.1016/j.jpba.2023.115529 Preclinical
    https://doi.org/10.1016/j.jpba.2023.115529
  11. Sadler, C., Vanderjagt, L. and Vohra, S (2007) 'Complementary, holistic, and integrative medicine: butterbur', Pediatrics in Review. doi:10.1542/pir.28-6-235 Preclinical
    https://doi.org/10.1542/pir.28-6-235
  12. Guo, R. and Pittler, M.H. and Ernst, E (2007) 'Herbal medicines for the treatment of allergic rhinitis: a systematic review', Annals of Allergy, Asthma & Immunology, 99(6), pp. 483--495. doi:10.1016/S1081-1206(10)60375-4 Meta-analysis / review
    https://doi.org/10.1016/S1081-1206(10)60375-4
  13. Grossmann, M. and Schmidramsl, H (2000) 'An extract of Petasites hybridus is effective in the prophylaxis of migraine', International Journal of Clinical Pharmacology and Therapeutics, 38(9), pp. 430--435. doi:10.5414/cpp38430 Randomized trial
    https://doi.org/10.5414/cpp38430
  14. Sperl, W. and Stuppner, H. and Gassner, I. and Judmaier, W. and Dietze, O. and Vogel, W (1995) 'Reversible hepatic veno-occlusive disease in an infant after consumption of pyrrolizidine-containing herbal tea', European Journal of Pediatrics, 154(2), pp. 112-6. doi:10.1007/BF01991912 Clinical study
    https://doi.org/10.1007/BF01991912

Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.