Drug & supplement interaction

Neem + Methylprednisolone

Methylprednisolone brand names: Medrol, Medrol Dosepak.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Methylprednisolone 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?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Neem and Methylprednisolone

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. Methylprednisolone 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 Methylprednisolone

Methylprednisolone 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 gist for combining neem with methylprednisolone. Your body uses a tiny pump called P-glycoprotein to help move this steroid around and clear it out. Lab studies hint that neem leaf extract may slow that pump down. If that happened in real life, a bit more methylprednisolone could linger in your system, which in theory could nudge up steroid side effects like a puffy face, trouble sleeping, mood swings, higher blood sugar, fluid retention, or stomach upset.

I want to be honest with you: this is only seen in test-tube and animal research, never reported in actual people, so it's more of a 'good to know' than a real alarm. Food or tea amounts of neem are unlikely to matter. Before starting a neem supplement, just give your pharmacist or doctor a heads-up.

Contact Dr. Brian directly if you have additional questions on this interaction
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

Methylprednisolone 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: your body uses a liver enzyme called CYP3A4 to break down methylprednisolone. In test-tube studies, a methanol extract of neem leaf appeared to slow that same enzyme down. If neem did that in real life, your body would clear methylprednisolone a little more slowly, so more of it could linger and its effects (and side effects) could be stronger. With steroids, that might mean things like trouble sleeping, mood swings, stomach upset, higher blood sugar, fluid retention, or a bigger dip in your immune defenses.

I want to be honest, though: this is theory based only on lab work, and it hasn't been seen in actual people. Food-level uses of neem are unlikely to matter, but concentrated supplements are less predictable. Before pairing them, check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
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

Methylprednisolone 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 gist with Neem and methylprednisolone. Methylprednisolone is a steroid that works partly by calming down an overactive immune system, which is why it helps with things like arthritis flares, bad allergies, asthma, and inflammatory gut conditions. Neem, on the other hand, has been shown in animal and lab studies to nudge the immune system in the opposite direction, giving it a little boost.

So in theory, neem could push against what your steroid is trying to do and make it work a bit less well, meaning your symptoms might not stay as controlled. I want to be honest though: this is based on early research, not solid human studies, so it's more of a heads-up than a red alert. Before adding neem, just run it by your pharmacist or doctor so they can weigh in for your situation.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Methylprednisolone one above is among them. If you take anything else, check it against the full list below.

Moderate 1,012 No known interaction 1,818 (incl. Methylprednisolone)
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.

From our Q&A

Questions About Neem or Methylprednisolone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Neem or Methylprednisolone, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Methylprednisolone

This page covers Neem only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Methylprednisolone page lists 207 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).

By severity: 4 major · 167 moderate · 36 minor.

From our pharmacist’s overview on the Methylprednisolone page

“Methylprednisolone (Medrol) is a steroid used for inflammation, allergic flares, and autoimmune disease, and its supplement interactions deserve real attention, not a quick skim. Of the 207 ingredients on file, four rate major, and those come first: grapefruit and St.”

Reviewed by 2 · Jul 18, 2026

Open the Methylprednisolone 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 Methylprednisolone 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 Methylprednisolone 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%

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

29 days ago today
Medication Methylprednisolone
Top 25%

#614 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 Methylprednisolone

What Is Methylprednisolone Used For?

Brand names: Medrol, Medrol Dosepak

Methylprednisolone tablets (Medrol, Methylpred DP) are used to treat a broad set of conditions including endocrine disorders, rheumatic and joint conditions, autoimmune diseases such as systemic lupus erythematosus, severe allergic states, skin diseases, eye inflammation, breathing disorders like asthma, blood and kidney diseases, and certain cancers.

Methylprednisolone acetate injection (Depo-Medrol and others) is used by intramuscular injection when oral therapy isn't feasible, and can also be given directly into joints, soft tissue, or lesions to treat local inflammation from conditions such as rheumatoid arthritis, bursitis, and skin disorders. The injection is not approved for intrathecal (spinal) use.

See full Methylprednisolone 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
1,012 Moderate 1,817 No 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

We also checked Neem against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,817 medications checked with no known interaction — see the full Neem list.

See the full Neem interactions page
See every supplement checked against Methylprednisolone, ranked by severity
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

Keep exploring
Neem monograph › Uses, safety, and every drug interaction in one place Methylprednisolone supplement interactions › Every supplement checked against Methylprednisolone, ranked by severity Methylprednisolone drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Neem and Methylprednisolone Together: Common Questions

Can you take Neem with Methylprednisolone?
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 Methylprednisolone?
Methylprednisolone 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 Methylprednisolone 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

Still Have a Question About Methylprednisolone and Neem?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.