Drug & supplement interaction

Neem + Beclomethasone dipropionate

Beclomethasone dipropionate brand names: Qvar, QNASL.

Moderate Interaction
The bottom line Moderate

Beclomethasone dipropionate falls into 3 drug categories that Neem can interact with; the most serious is rated moderate. Theoretically, neem leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Neem and Beclomethasone dipropionate

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Neem interacts with whole categories of medication. Beclomethasone dipropionate falls into 3 of those categories, so it can interact with Neem in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 3

Why this applies to Beclomethasone dipropionate

Beclomethasone dipropionate falls under P-GLYCOPROTEIN SUBSTRATES — the group Neem interacts with.

Theoretically, neem leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that neem leaf methanol extract inhibits renal P-glycoprotein transport activity. So far, this reaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the short version: in lab dishes, neem leaf extract slowed down a transporter called P-glycoprotein, which is one of the body's ways of moving certain drugs around and clearing them. In theory, blocking that pump could let levels of a P-glycoprotein drug like beclomethasone (Qvar, QNASL) creep up a bit. If that happened, you might see more typical inhaled steroid side effects, things like mouth or throat irritation, hoarseness, or oral thrush.

But I want to keep this in perspective. This is only theoretical, based on test-tube work, and has never actually been reported in people. Beclomethasone is also inhaled or sprayed in the nose, so very little reaches your bloodstream to begin with. I wouldn't lose sleep over it, but it's always worth mentioning neem to your pharmacist or doctor.

References
  1. Amaeze O, Marques ES, Wei W, et al. Evaluation of Nigerian Medicinal Plants Extract on Human P-glycoprotein and Cytochrome P450 Enzyme Induction: Implications for Herb-drug Interaction. Curr Drug Metab. 2021;22(14):1103-1113. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 3

Beclomethasone dipropionate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, neem leaf extract might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that neem leaf methanol extract inhibits CYP3A4 enzymes. So far, this reaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your inhaler. Your body uses an enzyme called CYP3A4 to help clear beclomethasone (Qvar, QNASL). In lab dishes, neem leaf extract has slowed that same enzyme down. In theory, that could let a bit more steroid linger in your system, which might mean slightly stronger steroid effects over time, things like throat irritation, oral thrush (a white mouth infection), hoarseness, or, with bigger build-up, more general steroid side effects.

The good news: this is only seen in test-tube studies and has not been reported in real people. Inhaled beclomethasone also acts mostly right in your airways, so the risk is likely small. Still, if you take concentrated neem supplements, mention it to your pharmacist or doctor first.

References
  1. Amaeze O, Eng H, Horlbogen L, Varma MVS, Slitt A. Cytochrome P450 Enzyme Inhibition and Herb-Drug Interaction Potential of Medicinal Plant Extracts Used for Management of Diabetes in Nigeria. Eur J Drug Metab Pharmacokinet. 2021;46(3):437-450. PubMed
Moderate

IMMUNOSUPPRESSANTS

3 of 3

Beclomethasone dipropionate also falls under IMMUNOSUPPRESSANTS.

Theoretically, neem might decrease the effectiveness of immunosuppressants.
Animal research suggests that neem might have immunostimulant effects.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing about this one: the concern is that neem may gently nudge the immune system to be more active, which in theory could work against medicines that calm immune activity. Your inhaled beclomethasone (Qvar) is a steroid that quiets swelling and irritation in your airways. So the worry is that neem could blunt how well it controls your asthma, meaning more wheezing, coughing, or chest tightness.

But I want to be honest about how weak this is. It comes only from lab and animal studies, not real people, and inhaled beclomethasone mostly acts right in your lungs rather than throughout your whole body. A meaningful clash is unlikely. Still, neem swallowed in concentrated form can be risky on its own, so please check with your pharmacist or doctor before using it.

References
  1. Upadhyay SN, Dhawan S, Garg S, Talwar GP. Immunomodulatory effects of neem (Azadirachta indica) oil. Int J Immunopharmacol 1992;14:1187-93. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Neem Also Interacts With Other Medications

Neem has 1,012 moderate known drug interactions in our database — the Beclomethasone dipropionate one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Neem

Covers the 2,830 medications we’ve checked against Neem. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Beclomethasone dipropionate

This page covers Neem only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Beclomethasone dipropionate page lists 202 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lily-of-the-valley (major), St. John's Wort (major) and Acacia Rigidula (moderate).

Open the Beclomethasone dipropionate interaction page

One more smart check

Taking Neem as Part of a Dietary Supplement Product? Check It for Interactions

We hold 288 real supplement products containing Neem, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Neem. Your product may carry other ingredients that interact with Beclomethasone dipropionate too, on top of Neem — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Neem and Beclomethasone dipropionate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Neem
Top 25%

#359 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Beclomethasone dipropionate
Steady interest

#2,098 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Neem

What is Neem?

Neem
  • Skin conditions
  • Dental and gum health
  • Antimicrobial and antiparasitic
  • Digestive upset
  • Blood sugar support
  • Insect repellent/pesticide

Neem is a tree from India used for centuries in traditional medicine, especially for skin, dental, and antimicrobial purposes. Some small studies are promising for oral health and skin, but high-quality human evidence is limited for most uses. Neem oil and seed extracts can be toxic if swallowed, especially in children, so use with caution and talk to your pharmacist or doctor first.

Read the full Neem monograph & all interactions
Medication

About Beclomethasone Oral Inhalation

What Is Beclomethasone Oral Inhalation Used For?

Brand names: Qvar, QNASL

Beclomethasone dipropionate HFA inhalation aerosol (brand: Qvar Redihaler) is used for the ongoing, daily management of asthma in adults and children 5 years of age and older. It is a preventive (maintenance) therapy — not a rescue inhaler — meaning it helps control asthma over time rather than treating sudden symptoms.

Important: Qvar Redihaler is not for the relief of sudden asthma attacks or acute bronchospasm. Always keep a separate fast-acting (rescue) inhaler on hand for those moments.

See full Beclomethasone Oral Inhalation drug information
Keep checking

Other Drugs & Neem

Browse every other medication we’ve checked against Neem — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
1,012Moderate
0Minor
1,817No known interaction
Moderate

1,012 interactions

Showing 60 of 1,012 moderate interactions — see all 1,012 on the Neem page.

No interaction 1,817 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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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Pharmacist Counseling Corner

Taking Neem and Beclomethasone dipropionate Together: Common Questions

Can you take Neem with Beclomethasone dipropionate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Neem and Beclomethasone dipropionate?
Beclomethasone dipropionate belongs to more than one drug category, and Neem interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Neem and Beclomethasone dipropionate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.