Neem + Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate brand names: Estrostep Fe, Loestrin Fe, Microgestin FE, Junel Fe 1.5/30, Loestrin Fe 1.5/30, and others.
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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 CYP1A2 substrates.
Read the full interaction reportNeem and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
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. Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 3Why this applies to Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Neem interacts with.
In vitro research shows that neem leaf extract inhibits CYP1A2 enzymes. So far, this reaction has not been reported in humans.
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.
Here's the short version: your birth control pill (Loestrin Fe and similar) contains ethinyl estradiol, and that estrogen is partly broken down by a liver enzyme called CYP1A2. In test-tube studies, neem leaf extract seems to slow that same enzyme down. In theory, that could let estrogen levels drift a little higher, which might mean more of the usual estrogen-type side effects like nausea, breast tenderness, bloating, or headaches.
The important part: this has only been seen in lab dishes, never reported in real people, so the concern is very theoretical. Occasional culinary or skincare neem is unlikely to matter, while concentrated neem capsules are the bigger question mark. Before adding a neem supplement, just run it by your pharmacist or doctor.
- 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
P-GLYCOPROTEIN SUBSTRATES
2 of 3Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under 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.
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.
If you're taking a birth control pill like Loestrin Fe or Microgestin Fe along with neem, here's the honest picture. The hormones in your pill (ethinyl estradiol and norethindrone) are moved around the body partly by a transporter called P-glycoprotein. In lab dish studies, neem leaf extract seemed to slow that transporter down. In theory, that could let a little more hormone hang around, which might mean more of the usual things like nausea, breast tenderness, bloating, or spotting.
The key word is theoretical. This has only been seen in test tube and animal work, never reported in real people, so I wouldn't lose sleep over it. Still, since these pills matter, just mention your neem use to your pharmacist or doctor before combining them.
- 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
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Ethinyl Estradiol, Norethindrone, Ferrous Fumarate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that neem leaf methanol extract inhibits CYP3A4 enzymes. So far, this reaction has not been reported in humans.
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.
Your birth control pill contains ethinyl estradiol and norethindrone, which your liver clears using an enzyme called CYP3A4 (the iron, or ferrous fumarate, is just a supplement and isn't part of this issue). In lab dish studies, neem leaf extract slowed that same enzyme. If that happened in your body, it could let a bit more estrogen build up, which might mean more of the usual side effects like nausea, breast tenderness, bloating, or mood changes.
Here's the honest part: this is purely theoretical right now. It comes from test-tube research, not from real people, and it has never actually been reported in anyone taking the combo. Food-style or dental uses of neem are very unlikely to matter. Still, if you're thinking about neem supplements, run it past your pharmacist or doctor first.
- 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
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Neem Also Interacts With Other Medications
Neem has 1,013 moderate known drug interactions in our database — the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Neem
We haven’t checked that one against Neem yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Neem. Pick one to open its full report.
See Every Supplement That Interacts With Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
This page covers Neem only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate page lists 240 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).
By severity: 6 major · 196 moderate · 38 minor.
From our pharmacist’s overview on the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate page
“If you take a birth control pill that combines ethinyl estradiol, norethindrone, and iron (Loestrin Fe, Estrostep Fe, Microgestin Fe), a few supplements can genuinely undermine it, and I want you to know which ones first. Six of the 240 ingredients on file carry a major rating.”
Reviewed by 2 · Jul 18, 2026
Open the Ethinyl Estradiol, Norethindrone, Ferrous Fumarate interaction page
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 Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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:
Where Neem and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate 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.
#402 of 1,452 supplements looked up here in the last 7 days
#244 of 2,830 medications looked up here in the last 7 days
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.
About Neem
What is 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.
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.
No drugs match “”.
1,013 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Insulin (human) ›
- Miconazole ›
- Morphine Sulfate ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Ivabradine ›
- Ivermectin ›
- Lofepramine ›
Showing 60 of 1,013 moderate interactions — see all 1,013 on the Neem page.
No interaction 1,816 drugs checked — show the list
We also checked Neem against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Aspirin ›
- Metoprolol ›
- Levothyroxine, Liothyronine ›
- Docusate ›
- Methamphetamine ›
- Lisdexamfetamine ›
- Hydroxyurea ›
- Valacyclovir ›
- Amphetamine ›
- Sumatriptan ›
- Methotrexate ›
- Lisinopril ›
- Amoxicillin ›
- Bupropion ›
- Azithromycin ›
- Pregabalin ›
- Gabapentin ›
- Dextroamphetamine ›
- Lamotrigine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Bisoprolol ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Amphetamine Aspartate, Amphetamine Sulfate, Dextroamphetamine Saccharate, Dextroamphetamine Sulfate ›
- Aminophylline, Amobarbital, Ephedrine ›
- Atenolol, Chlorthalidone ›
- Aspirin, Butalbital ›
- Enalapril Maleate ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Ephedrine, Phenobarbital, Theophylline ›
- Cephalexin ›
- Ezetimibe ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Levetiracetam ›
- Levodopa ›
- Cyclopentolate ›
- Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide ›
- Aspirin, Ethoheptazine, Meprobamate ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Daunorubicin, Cytarabine ›
- Candesartan Cilexetil, Hydrochlorothiazide ›
- Sodium Bicarbonate (otc Drug) ›
- Amobarbital, Ephedrine Sulfate ›
- Alginic Acid, Aluminum Hydroxide ›
- Measles, Mumps, Rubella Virus Live ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Cytomegalovirus Immune Globulin ›
Showing the 60 most looked-up of 1,816 medications checked with no known interaction — see the full Neem list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate Is Linked to Lower Levels of 7 Nutrients
Natural Medicines records Ethinyl Estradiol, Norethindrone, Ferrous Fumarate as a medicine that can lower these. This is not an interaction with Neem — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Ethinyl Estradiol, Norethindrone, Ferrous Fumarate nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Neem and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate Together: Common Questions
Can you take Neem with Ethinyl Estradiol, Norethindrone, Ferrous Fumarate?
Why are there 3 interactions listed for Neem and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate?
How serious is the Neem and Ethinyl Estradiol, Norethindrone, Ferrous Fumarate interaction?
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.