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Scientific Name(s): Petasites frigidus (L.) Fr., Petasites hybridus (L.) G. Gaertner, Meyer and Scherb., Petasites japonicas Siebold & Zucc. Maxim.
Common Name(s): Arctic sweet coltsfoot (P. frigidus), Blatterdock, Bog rhubarb, Bogshorns, Butter-dock, Butterbur, Butterfly dock, Coltsfoot, Exwort, Fuki, Japanese sweet coltsfoot (P. japonicas), Pestilence-wort (P. hybridus), Pestwurz

Medically reviewed by Last updated on Feb 15, 2021.

Clinical Overview


Limited clinical trials of variable methodological quality suggest a possible place in therapy for asthma and the prophylaxis of migraines in adults and children, as well as in intermittent (seasonal) allergic rhinitis. However, recommendations are based on weak clinical efficacy information but with a low potential for side effects. Only commercial preparations that are certified not to contain toxic pyrrolizidine alkaloids should be used.


Migraine prophylaxis in adults: Butterbur extract 50 to 75 mg twice daily for 4 months.

Migraine prophylaxis in children 6 to 9 years: Butterbur extract 50 to 75 mg/day in 2 divided doses.

Migraine prophylaxis in children and adolescents 9 to 17 years: Butterbur extract 100 to 150 mg/day in 2 divided doses.


Avoid in hepatic impairment. Limited animal studies suggest butterbur's chemical constituents may exert cardiovascular effects.


Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic activity.


None well documented.

Adverse Reactions

GI symptoms, including nausea, flatulence, and belching, are the most common documented adverse reactions. Allergies, including anaphylaxis, have been reported.


Preparations may contain pyrrolizidine alkaloids with carcinogenic and mutagenic potential; commercial products typically are certified as pyrrolizidine free ("PA free"); however, levels of active petasins as well as toxic alkaloids have been found to be highly variable and incongruent with their labeling. Possible hepatotoxicity has been reported.

Scientific Family

  • Asteraceae (Aster)


Butterbur is a perennial shrub native to Europe that commonly grows in wet, marshy ground or on sandbars near streams. Its distinctive pink-lilac flowers grow on large spikes that appear in spring before its large, downy leaves emerge. P. japonicas is commonly grown and consumed in Japan.1, 2

Although sometimes considered synonymous with Tussilago farfara, butterbur and coltsfoot are detailed separately (see Coltsfoot monograph).


The botanical name Petasites is derived from the Greek word petasos, a type of broad-brimmed hat worn by shepherds, referring to the plant's broad, downy leaves. The name butterbur relates to the use of the leaves to wrap butter during warm weather. During the Middle Ages, butterbur leaves and roots were used to treat cough, plague, and fever.

P. japonicus is a common vegetable in Japan and Taiwan; the baked flower bud is used in traditional medicine as an expectorant or in the treatment of asthma. Other traditional uses include the treatment of gastric ulcer and bee stings.2, 3


Butterbur contains senecionine and other toxic pyrrolizidine alkaloids in the leaf and root; a competitive immunoassay has been developed for the determination of alkaloid content. High-performance liquid chromatography (HPLC) analyses of both plant parts indicate that, on average, alkaloid levels are lower in leaves than in roots.2, 3, 4

A large number of sesquiterpenes have been isolated from butterbur, with petasin and related eromophilanes being the most pharmacologically important. The sesquiterpene distribution varies according to plant part, growth season, and plant location. Use of HPLC methods for quantitative determination of petasin has been reported, and the existence of a distinct chemovar with furanoeremophilanes has been noted.2, 5

The petasin series of compounds are unstable in storage; rearrangements occur in dry plant materials and in stored extracts. The biosynthesis of petasin has been elucidated. Differences in the sesquiterpene profiles of various European Petasites species have been studied. Other constituents of butterbur include the flavonoid glycosides isoquercitrin and astralagin.5

Uses and Pharmacology

Only commercial preparations that are certified not to contain toxic pyrrolizidine alkaloids should be used.6

Allergic rhinitis

Animal data

The availability of clinical trial data makes animal studies largely unwarranted.

Clinical data

Several clinical trials have been conducted on commercial preparations of butterbur to evaluate their efficacy in the management of allergic rhinitis. Subjective and objective data serve as end points and measures of efficacy. However, 3 of the larger trials were sponsored by manufacturers of butterbur extract and at least 1 study with negative results has been published.7

Mechanisms of action for butterbur in allergic rhinitis relate to a role in leukotriene activity rather than an antihistaminic effect. The Global Allergy and Asthma European Network Guidelines on Allergic Rhinitis and its Impact on Asthma (ARIA) (2010) conditionally recommend that butterbur not be used in patients with allergic rhinitis based on the very low-quality evidence of benefit and the high risk of adverse effects.6

The American Association of Otolaryngology-Head and Neck Surgery (AAOHNS) clinical practice guideline on allergic rhinitis (2015) states that too few data are available to make recommendations on the use of butterbur for managing symptoms of allergic rhinitis. Additionally, no recommendations could be made regarding use of herbal therapies, in general, based on the limited knowledge of herbal medicines by the panel and their concerns about quality of standardization and safety (low; uncertain).50


Animal data

Studies of Petasites extracts in rodents have shown a decrease in airway hyperresponsiveness, including inhibition of eosinophil infiltration and mucus hypersecretion, as well as relaxation of tracheal tissues. Decreases in circulating levels of histamine and leukotrienes have been shown.8, 9, 10, 11, 12

Clinical data

There are limited clinical trials evaluating the efficacy of butterbur extracts in asthma. One small trial (N = 16) found improvement in the primary outcome of bronchial hyperresponsiveness with butterbur 50 mg/day taken for 1 week.13 A reduction in asthma attacks was reported in another open-design trial after subjects were administered 150 mg/day.14

Migraine prophylaxis, adults

Animal data

Information is lacking; however, the widespread use of butterbur for the prevention of migraine and the availability of clinical trial data make animal studies largely irrelevant.

Clinical data

Earlier support for use of butterbur for prevention of episodic migraines in adults by the 2012 American Academy of Neurology and American Headache Society guidelines was withdrawn in 2015 subsequent to serious concerns over the safety of unregulated manufacturing processes that were not removing toxic pyrrolizidine alkaloids from commercially-available products. Additionally, levels of the active moiety, petasins, were found to be highly variable and even lacking in some products.15, 51, 52, 53

The Canadian Headache Society guidelines for migraine prophylaxis (2012) strongly recommend butterbur 75 mg twice daily for eligible patients for migraine prophylaxis based on moderate evidence (controlled trials), noting that the magnitude of benefit may be small, but side effects are minimal.16 Likewise, the European Federation of Neurological Societies guidelines on the treatment of migraines (2009) considers butterbur (petasites) as second line therapy for migraine prophylaxis based on moderate evidence.17 Meta-analysis suggests that butterbur 50 mg twice daily achieves a 50% reduction in migraine frequency at week 12 (odds ratio, 2.24; 95% confidence interval, 0.64 to 7.81; P = 0.2)15

The safety of long-term use of butterbur has not been established. The maximum duration studied in clinical trials for migraine was 16 weeks.15, 18

Migraine prophylaxis, children

Animal data

Information is lacking; however, the widespread use of butterbur for the prevention of migraine and the availability of clinical trial data make animal studies largely irrelevant.

Clinical data

One open-label study has been conducted in children and adolescents 6 to 17 years of age.18 A second trial evaluated the per-protocol efficacy of music versus butterbur against placebo. A reduction in the primary outcome of migraine frequency was shown for butterbur but not for the secondary outcome responder rate. After 6 months, efficacy was equivalent to placebo.19 Reviews of the data have been published.20, 21, 22 The safety of long-term use of butterbur has not been established.

Other uses


In rat gastric ulceration models, butterbur extract blocked the effects of ethanol and indomethacin.23, 24, 25


The active chemical components of butterbur in in vitro experiments have demonstrated the antioxidant effect of the active chemical components.26, 27, 28, 29, 30, 31


Methanol extracts of the leaves of P. japonicus were antimutagenic in human cancer and rat liver cell lines.32


The active chemical component petasin has been investigated for reported hypotensive effects. In in vitro experiments and in rat studies, both the S- and iso-S forms of petasin exerted a negative chronotropic effect on cardiac tissue. Reduced rates of atrial firing and a dose-dependent bradycardiac effect have been demonstrated. At the cellular level, blockade of the calcium channels was suggested, but the mechanism of action has not been established.33, 34, 35, 36, 37


The addition of butterbur extract to a 3-herb preparation increased its efficacy in a trial among patients with somatoform disorders.38


Petasin modulated glucose metabolism in mice.39

Immune system

In vitro studies showed immunomodulatory effects of P. hybridus extracts.40


Decreased total cholesterol and low-density lipoproteins have been shown in mice fed high-fat diets and butterbur extracts.38, 41


Various commercial preparations are available. Only commercial preparations that do not contain hepatotoxic pyrrolizidine alkaloids should be used.6 Studies in special populations, such as in patients with renal or hepatic function impairment, are not available.

Migraine prophylaxis in adults

Butterbur extract 50 to 75 mg twice daily for 4 months.16

Migraine prophylaxis in children 6 to 9 years

Butterbur extract 50 to 75 mg/day in 2 divided doses has been studied.18, 19, 20

Migraine prophylaxis in children and adolescents 9 to 17 years

Butterbur extract 100 to 150 mg/day in 2 divided doses has been studied.18, 19, 20

Pregnancy / Lactation

Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.42, 43


None well documented.44, 45 Interactions could occur with calcium channel antagonists, inotropic and anticholinergic medicines, and inducers of CYP3A4 (eg, St. John's wort, carbamazepine, phenytoin, rifampin), which might result in increased production of toxic metabolites of the alkaloids.

Adverse Reactions

Few adverse reactions have been reported in clinical trials; however, these trials have been of short duration (maximum, 16 weeks). GI symptoms, including nausea, flatulence, and belching, are the most common of documented adverse reactions. Headache, dizziness, drowsiness, and fatigue have also been reported, as well as allergy to butterbur or other members of the Aster family.16, 46 Anaphylaxis has been documented in 2 cases with dyspnea, full-body urticaria, and itching occurring within minutes of consuming Japanese butterbur scape tempura.54 Clinical trials have reported mild elevation of liver enzymes with no clinical sequelae.18 (See Toxicology.)


Pyrrolizidine alkaloids have carcinogenic and mutagenic potential. 3, 42 Commercial butterbur preparations utilize an extraction process to remove the pyrrolizidine alkaloids content; these products should be labeled as "PA free." Concentrations greater than 37% petasin are toxic.18, 47 The German Federal Health Bureau established regulations that restrict oral exposure to pyrrolizidine alkaloids or their N-oxides to 1 mcg/day (not to exceed 6 weeks duration) or 0.1 mcg/day of any duration for non-pregnant, non-lactating adults. However, analysis of 21 commercially available dietary supplements in 2012 found 7 products to contain pyrrolizidine alkaloids; 6 solid formulations contained 0.1 to 4.48 mcg/dosage form and 1 liquid product was found to have 8.43 mcg/mL. Typically, doses are taken 2 to 3 times daily with meals. Additionally, 5 of the 7 products containing toxic alkaloids had no detectable level of the pharmacologically active petasins. Only 7 of the 21 dietary supplement products tested were found to have petasins within the limits claimed on the label plus no toxic pyrrolizidine alkaloids.53

Postmarketing pharmacovigilance between 1992 and 2006 revealed 40 cases of increased liver enzymes and possible hepatotoxicity with P. hybridus extracts, 9 as acute hepatitis and 2 as liver failure.48 Clinical trials have reported mild elevation of liver enzymes with no clinical sequelae.18

Acute toxicity studies in rats showed no hepatotoxicity. Dose-related bile duct hyperplasia and increased liver enzymes were found at 28 days and 6 months, returning to normal after cessation.48 Extracts of P. japonicus were not mutagenic in the Ames Salmonella typhimurium test.32 Inhibition of testosterone production has been reported in animal experiments.49

Index Terms

  • Tussilago farfara


1. Petasites Mill. USDA, NRCS. 2014. The PLANTS Database (, 4 August 2014). National Plant Data Team, Greensboro, NC 27401-4901 USA. Accessed November 7, 2014.
2. Aydin AA, Zerbes V, Parlar H, Letzel T. The medical plant butterbur (Petasites): analytical and physiological (re)view. J Pharm Biomed Anal. 2013;75:220-229.23277154
3. Duke J, Bogenschutz-Godwin M, duCellier J, Duke P. Handbook of medicinal herbs. 2nd ed. Boca Raton, FL: CRC Press; 2002.
4. Duke J. Dr. Duke's phytochemical and ethnobotanical databases.
5. Wang S, Jin DQ, Xie C, et al. Isolation, characterization, and neuroprotective activities of sesquiterpenes from Petasites japonicus. Food Chem. 2013;141(3):2075-2082.23870930
6. Brozek JL, Bousquet J, Baena-Cagnani CE, et al; Global Allergy and Asthma European Network; Grading of Recommendations Assessment, Development and Evaluation Working Group. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466-476.20816182
7. Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol. 2007;99(6):483-495.18219828
8. Shih CH, Huang TJ, Chen CM, Lin YL, Ko WC. S-Petasin, the main sesquiterpene of Petasites formosanus, inhibits phosphodiesterase activity and suppresses ovalbumin-induced airway hyperresponsiveness. Evid Based Complement Alternat Med. 2011;2011:132374.19641087
9. Lee JS, Yang EJ, Yun CY, Kim DH, Kim IS. Suppressive effect of Petasites japonicus extract on ovalbumin-induced airway inflammation in an asthmatic mouse model. J Ethnopharmacol. 2011;133(2):551-557.21029770
10. Brattström A, Schapowal A, Maillet I, Schnyder B, Ryffel B, Moser R. Petasites extract Ze 339 (PET) inhibits allergen-induced Th2 responses, airway inflammation and airway hyperreactivity in mice. Phytother Res. 2010;24(5):680-685.19827027
11. Zhang FJ, Wang Q, Wang Y, Guo ML. Anti-allergic effects of total bakkenolides from Petasites tricholobus in ovalbumin-sensitized rats. Phytother Res. 2011;25(1):116-121.20625987
12. Lee KP, Kang S, Park SJ, Choi YW, Lee YG, Im DS. Anti-allergic and anti-inflammatory effects of bakkenolide B isolated from Petasites japonicus leaves. J Ethnopharmacol. 2013;148(3):890-894.23711828
13. Lee DK, Haggart K, Robb FM, Lipworth BJ. Butterbur, a herbal remedy, confers complementary anti-inflammatory activity in asthmatic patients receiving inhaled corticosteroids. Clin Exp Allergy. 2004;34(1):110-114.14720270
14. Danesch UC. Petasites hybridus (butterbur root) extract in the treatment of asthma—an open trial. Altern Med Rev. 2004;9(1):54-62.15005644
15. Holland S, Silberstein SD, Freitag F, Dodick DW, Argoff C, Ashman E; Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78(17):1346-1353.22529203
16. Canadian Headache Society Prophylactic Guidelines Development Group. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci. 2012;39(2 suppl 2):1-62.
17. Evers S, Afra J, Frese A, et al; European Federation of Neurological Societies. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol. 2009;16(9):968-981.19708964
18. Sutherland A, Sweet BV. Butterbur: an alternative therapy for migraine prevention. Am J Health Syst Pharm. 2010;67(9):705-711.20410544
19. Pothmann R, Danesch U. Migraine prevention in children and adolescents: results of an open study with a special butterbur root extract. Headache. 2005;45(3):196-203.15836592
20. 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(3):301-313.17659990
21. Orr SL, Venkateswaran S. Nutraceuticals in the prophylaxis of pediatric migraine: evidence-based review and recommendations. Cephalalgia. 2014;34(8):568-583.24443395
22. Utterback G, Zacharias R, Timraz S, Mershman D. Butterbur extract: prophylactic treatment for childhood migraines. Complement Ther Clin Pract. 2014;20(1):61-64.24439647
23. Diener HC, Rahlfs VW, Danesch U. The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: reanalysis of efficacy criteria. Eur Neurol. 2004;51(2):89-97.14752215
24. Brune K, Bickel D, Peskar BA. Gastro-protective effects of extracts of Petasites hybridus: the role of inhibition of peptido-leukotriene synthesis. Planta Med. 1993;59(6):494-496.8302945
25. Chizzola R, Ozelsberger B, Langer T. Variability in chemical constituents in Petasites hybridus from Austria. Biochem Syst Ecol. 2000;28(5):421-432.10725599
26. Sok DE, Oh SH, Kim YB, Kang HG, Kim MR. Neuroprotection by extract of Petasites japonicus leaves, a traditional vegetable, against oxidative stress in brain of mice challenged with kainic acid. Eur J Nutr. 2006;45(2):61-69.15997340
27. Oh SH, Sok DE, Kim MR. Neuroprotective effects of butterbur and rough aster against kainic Acid-induced oxidative stress in mice. J Med Food. 2005;8(2):169-176.16117608
28. Cui HS, Kim MR, Sok DE. Protection by petaslignolide A, a major neuroprotective compound in the butanol extract of Petasites japonicus leaves, against oxidative damage in the brains of mice challenged with kainic acid. J Agric Food Chem. 2005;53(22):8526-8532.16248548
29. Matsuura H, Amano M, Kawabata J, Mizutani J. Isolation and measurement of quercetin glucosides in flower buds of Japanese butterbur (Petasites japonicus subsp. gigantea Kitam.). Biosci Biotechnol Biochem. 2002;66(7):1571-1575.12224645
30. Lin CH, Li CY, Wu TS. A novel phenylpropenoyl sulfonic acid and a new chlorophyll from the leaves of Petasites formosanus KITAMURA. Chem Pharm Bull (Tokyo). 2004;52(9):1151-1152.15340211
31. Park CH, Kim MY, Sok DE, Kim JH, Lee JH, Kim MR. Butterbur (Petasites japonicus Max.) extract improves lipid profiles and antioxidant activities in monosodium L-glutamate-challenged mice. J Med Food. 2010;13(5):1216-1223.20828319
32. Kang HG, Jeong SH, Cho JH. Antimutagenic and anticarcinogenic effect of methanol extracts of Petasites japonicus Maxim leaves. J Vet Sci. 2010;11(1):51-58.20195065
33. Wang GJ, Shum AY, Lin YL, et al. Calcium channel blockade in vascular smooth muscle cells: major hypotensive mechanism of S-petasin, a hypotensive sesquiterpene from Petasites formosanus. J Pharmacol Exp Ther. 2001;297(1):240-246.11259550
34. Wang GJ, Liao JF, Hintz KK, et al. Calcium-antagonizing activity of S-petasin, a hypotensive sesquiterpene from Petasites formosanus, on inotropic and chronotropic responses in isolated rat atria and cardiac myocytes. Naunyn Schmiedebergs Arch Pharmacol. 2004;369(3):322-329.15010899
35. Wang GJ, Wu XC, Lin YL, et al. Ca2+ channel blocking effect of iso-S-petasin in rat aortic smooth muscle cells. Eur J Pharmacol. 2002;445(3):239-245.12079689
36. Esberg LB, Wang GJ, Lin YL, Ren J. Iso-S-petasin, a hypotensive sesquiterpene from Petasites formosanus, depresses cardiac contraction and intracellular Ca2+ transients in adult rat ventricular myocytes. J Pharm Pharmacol. 2003;55(1):103-107.12625873
37. Wang GJ, Lin YL, Chen CH, Wu XC, Liao JF, Ren J. Cellular calcium regulatory machinery of vasorelaxation elicited by petasin. Clin Exp Pharmacol Physiol. 2010;37(3):309-315.19719750
38. Melzer J, Schrader E, Brattström A, Schellenberg R, Saller R. Fixed herbal drug combination with and without butterbur (Ze 185) for the treatment of patients with somatoform disorders: randomized, placebo-controlled pharmaco-clinical trial. Phytother Res. 2009;23(9):1303-1308.19274698
39. Adachi Y, Kanbayashi Y, Harata I, et al. Petasin activates AMP-activated protein kinase and modulates glucose metabolism. J Nat Prod. 2014;77(6):1262-1269.24871354
40. Khaleghi F, Jantan I, Din LB, Yaacob WA, Khalilzadeh MA, Bukhari SN. Immunomodulatory effects of 1-(6-hydroxy-2-isopropenyl-1-benzofuran-5-yl)-1-ethanone from Petasites hybridus and its synthesized benzoxazepine derivatives. J Nat Med. 2014;68(2):351-357.24154877
41. Watanabe T, Hata K, Hiwatashi K, Hori K, Suzuki N, Itoh H. Suppression of murine preadipocyte differentiation and reduction of visceral fat accumulation by a Petasites japonicus ethanol extract in mice fed a high-fat diet. Biosci Biotechnol Biochem. 2010;74(3):499-503.20208359
42. Blumenthal M, Goldberg A, Brinckmann J. Herbal medicine: Expanded commission E monographs. Newton, MA: Integrative Medicine Communications; 2000.
43. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
44. Ulbricht C, Chao W, Costa D, Rusie-Seamon E, Weissner W, Woods J. Clinical evidence of herb-drug interactions: a systematic review by the natural standard research collaboration. Curr Drug Metab. 2008;9(10):1063-1120.19075623
45. Chen XW, Sneed KB, Pan SY, et al. Herb-drug interactions and mechanistic and clinical considerations. Curr Drug Metab. 2012;13(5):640-651.22292789
46. Posadzki P, Watson L, Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med. 2013;13(1):7-12.23472485
47. Sun-Edelstein C, Mauskop A. Alternative headache treatments: nutraceuticals, behavioral and physical treatments. Headache. 2011;51(3):469-483.21352222
48. Anderson N, Meier T, Borlak J. Toxicogenomics applied to cultures of human hepatocytes enabled an identification of novel Petasites hybridus extracts for the treatment of migraine with improved hepatobiliary safety. Toxicol Sci. 2009;112(2):507-520.19770483
49. Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology. 2004;63(12):2240-2244.15623680
50. Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152(suppl 1):S1-S43.25644617
51. Mauskop A. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2013;80:868.23439703
52. American Academy of Neurology Board of Directors. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. [RETIRED]. Updated September 2015. Accessed October 2016.
53. Avula B, Wang YH, Wang M, Smillie TJ, Khan IA. Simultaneous determination of sesquiterpenes and pyrrolizidine alkaloids from the rhizomes of Petasites hybridus (L.) G.M. et Sch. and dietary supplements using UPLC-UV and HPLC-TOF-MS methods. J Pharm Biomed Anal. 2012;70:53-63.22809670
54. Kataoka Y, Tamagawa-Mineoka R, Masuda K, Katoh N. Anaphylaxis to Japanese butterbur scapes. Allergol Int. 2017;66(1):141-142.27451267


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