Drug & supplement interaction

Neem + Tisotumab Vedotin-Tftv

Tisotumab Vedotin-Tftv brand name: Tivdak.

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

Neem has a moderate interaction with Tisotumab Vedotin-Tftv. Theoretically, neem leaf extract might increase the levels and clinical effects of CYP3A4 substrates.

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

Neem and Tisotumab Vedotin-Tftv

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Tisotumab Vedotin-Tftv

Tisotumab Vedotin-Tftv falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Neem interacts with.

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 situation with Tivdak and neem. Tivdak is an antibody-drug conjugate given by IV for cervical cancer. After it delivers its payload (a chemo compound called MMAE) into cancer cells, that payload is partly broken down by a liver enzyme called CYP3A4. In lab studies only, neem leaf extract seems to slow down CYP3A4. If that held true in people, the MMAE could clear a little slower and build up, which might mean more side effects like nerve tingling or numbness, eye irritation, nausea, fatigue, bleeding, or low blood counts.

I want to be honest though: this is purely theoretical and has never been reported in humans. Still, since you're already on a serious cancer therapy, please run any neem supplement past your oncology team before using it.

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

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 Tisotumab Vedotin-Tftv one above is one of them. If you take anything else, check it against the full list below.

Moderate 1,012 No known interaction 1,818 (incl. Tisotumab Vedotin-Tftv)
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 Tisotumab Vedotin-Tftv

This page covers Neem only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tisotumab Vedotin-Tftv page lists 121 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate), Adrafinil (moderate) and African Wild Potato (moderate).

By severity: 2 major · 87 moderate · 32 minor.

From our pharmacist’s overview on the Tisotumab Vedotin-Tftv page

“If you are receiving tisotumab vedotin (Tivdak), an infusion used to treat cervical cancer, treat this page with real care and clear every supplement with your oncology team first. All 121 ingredients here act through the same liver enzyme, CYP3A4, which processes the chemotherapy portion of this drug.”

Reviewed by 2 · Jul 18, 2026

Open the Tisotumab Vedotin-Tftv 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 Tisotumab Vedotin-Tftv 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 Tisotumab Vedotin-Tftv 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 half

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

29 days ago today
Medication Tisotumab Vedotin-Tftv
Top 10%

#224 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 Tisotumab vedotin-tftv

What Is Tisotumab vedotin-tftv Used For?

Brand name: Tivdak

  • Tisotumab vedotin-tftv injection is used to treat cervical cancer (cancer that begins in the opening of the uterus [womb]) that has not improved or has come back after treatment with other medications or has spread to other parts of the body. Tisotumab vedotin-tftv is in a class of medications called antibody-drug conjugates. It works by killing cancer cells.

See full Tisotumab vedotin-tftv 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 Tisotumab Vedotin-Tftv, 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 Tisotumab Vedotin-Tftv supplement interactions › Every supplement checked against Tisotumab Vedotin-Tftv, ranked by severity Tisotumab vedotin-tftv 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 Tisotumab Vedotin-Tftv Together: Common Questions

Can you take Neem with Tisotumab Vedotin-Tftv?
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.
How serious is the Neem and Tisotumab Vedotin-Tftv 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 Tisotumab Vedotin-Tftv and Neem?

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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.