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Dietary supplement

Neem Alcohol Free Ingredients & Drug Interactions

by Hawaii Pharm

Liquid Category: Botanical
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Neem Alcohol Free is a dietary supplement by Hawaii Pharm with 1 active ingredient. Its ingredients are commonly taken for skin conditions, dental and gum health, antimicrobial and antiparasitic.Based on those ingredients, 1,013 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Neem Leaf Extract, Dry. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Neem Alcohol Free by Hawaii Pharm

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 1 of its 1 active ingredient.
  • No proprietary blends here — you can verify the dose of every single component.

Neem Alcohol Free is a liquid extract containing one active ingredient: neem leaf extract (dried form). The product also includes glycerin and water as inactive ingredients to hold and deliver the neem.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed

This product doesn't appear to be marketed for a specific use, so we graded Neem's overall clinical evidence instead.

Moderate

Some clinical evidence supports Neem for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredient's overall clinical evidence instead.
  • On file: Dental plaque — rated "Possibly Effective" (Natural Medicines).
  • On file: Gingivitis — rated "Possibly Effective" (Natural Medicines).
  • On file: Lice — rated "Possibly Effective" (Natural Medicines).

For gum disease (gingivitis) and dental plaque, neem leaf extract is possibly effective based on available research. It's also possibly effective for head lice.

For acne and tungiasis (a parasitic skin infection), the evidence isn't established well enough to rate it. If you're considering neem for any of these uses, talk it over with your doctor or dentist to see if it's right for your situation.

The evidence, ingredient by ingredient Neem

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 1 matched ingredient.
  • Pregnancy & breastfeeding safety ratings cover 1 of 1.
  • General safety write-ups exist for 1 of 1.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Neem leaf extract is generally well tolerated when taken by mouth in adults, though high-quality safety studies haven't been done. The most common side effect when applied to skin is contact dermatitis in sensitive people.

Serious side effects are rare but have been reported in adults (including cardiac arrest and kidney damage) and more commonly in children taking neem oil. The safety data advises against neem during pregnancy because it may affect fertility and pregnancy itself.

There isn't enough reliable safety information to use neem while breastfeeding.

Side effects, ingredient by ingredient Neem

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 1 of the 1 matched ingredient can interact with medications — Neem.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,014 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, double-check with your doctor or pharmacist if you take diabetes medications (moderate risk of low blood sugar), drugs processed by your liver as CYP1A2, CYP2C8, CYP2C9, or CYP3A4 substrates (moderate risk of higher drug levels), immunosuppressants like those used after transplant (moderate risk of reduced effectiveness), or medications transported by P-glycoprotein (moderate risk of higher drug levels). No interactions are documented for the inactive ingredients.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

Neem leaf extract may help with gum disease, plaque, or lice, but it carries moderate interaction risks with many common medications—especially diabetes drugs, where low blood sugar becomes a real concern. If you're on any prescription medications, check with your doctor or pharmacist before starting this product.

Neem should not be used during pregnancy or breastfeeding based on current safety data.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated Aug 23, 2023.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Neem Alcohol Free, straight from the product label.

Brand Hawaii Pharm
Barcode (UPC) 840253638083
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Aug 23, 2023
DSLD ID 300583
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Neem Alcohol Free by Hawaii Pharm, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
0.7 mL
Maximum serving Sizes:
1 mL
Servings per container
120
UPC/BARCODE
840253638083
IngredientAmount% DV
Neem Leaf Extract, Dry1156 mg--

Other ingredients: Glycerin, Water

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Brand IP Statement(s)

Hawaii Pharm Herbal Extract Highest quality since 2008

Suggested/Recommended/Usage/Directions

Suggested use: Shake well before using. For adults add about 20-30 drops (0.7-1 mL, one full squeeze of the dropper bulb) to some juice or water, up to 4 times a day.

Precautions

Warning: We recommend to seek expert medical advice before taking.

Do not use if you are allergic to any ingredients.

Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.

Consult your physician before giving to children under 18, during pregnancy, if nursing or taking medications.

May affect the ability to drive and operate machinery. May have contraindications, can cause side effects and adverse reactions. Do not use if seal is broken or missing.

Keep out of the reach of children!

Storage

Store in a cool dry place.

Seals/Symbols

cGMP Made in compliance with cGMP 21 CFR 111 in an FDA registered and inspected facility.

C2H5OH Alcohol free USA Made in United States of America

FDA Disclaimer Statement

This product has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.

General Statements

Scan this QR-code to get 15% discount on your next purchase. Limited time deal.

Formula

Azadirachta indica

Formulation

Only natural ingredients Purity is laboratory tested and verified

All the raw materials are gluten-free by their nature No artificial colors, flavors, or preservatives

Not tested on animals

C2H5OH Alcohol free

Made in USA, Hawaii

FDA Statement of Identity

Herbal Supplement

See for yourself

Neem Alcohol Free by Hawaii Pharm label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Neem Alcohol Free by Hawaii Pharm

This is the 1 active ingredient this product is made of. Select it to open its full monograph.

Serving size0.7 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.

Neem Leaf Extract, Dry

Interacts with
1,013 drugs
1156 mg per serving

Neem is a tree from India used for centuries in traditional medicine, especially for skin, dental, and antimicrobial purposes. Some small studies are...

Neem Leaf Extract, Dry monograph & interactions

Other (inactive) ingredients: Glycerin, Water. These complete the product’s ingredient list but are not active constituents.

Interaction report

Neem Alcohol Free by Hawaii Pharm Drug Interactions

Want to check YOUR meds against Neem Alcohol Free?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
1,013Drugs
1,013 Moderate

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in Neem Alcohol Free with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.

Neem Leaf Extract, Dry7 drug types · 1,013 drugs

Antidiabetes Drugs

Neem might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Some clinical research shows that neem can lower blood glucose levels in adults with type 2 diabetes, including those already taking metformin.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, neem leaf extract might increase the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that neem leaf extract inhibits CYP1A2 enzymes. So far, this reaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, neem leaf extract might increase the levels and clinical effects of CYP2C8 substrates.
In vitro research shows that neem leaf methanol extract inhibits CYP2C8 enzymes. So far, this reaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, neem leaf extract might increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that neem leaf methanol extract inhibits CYP2C9 enzymes. So far, this reaction has not been reported in humans.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, neem might decrease the effectiveness of immunosuppressants.
Animal research suggests that neem might have immunostimulant effects.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

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.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Neem Alcohol Free, from the product label.

Hawaii Pharm

See all Hawaii Pharm products
Name
Hawaii Pharm LLC
Street Address
510 Sumner St. Ste. 613
City
Honolulu
State
HI
ZipCode
96817
Phone Number
888-854-2924
Web Address
www.hawaiipharm.com
Pharmacist Counseling Corner

Neem Alcohol Free by Hawaii Pharm: Common Questions

Does Neem Alcohol Free by Hawaii Pharm interact with any medications?
Yes. Based on its ingredients, Neem Alcohol Free has a known interaction with 1,013 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Neem Alcohol Free contains a single active ingredient, and that one ingredient can interact with many different medications on its own. We check it against each medication and show the mechanism responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What is neem leaf extract, and what's it used for?
Neem is a tree native to India. Its leaf extract has been studied for gum disease, dental plaque, head lice, and acne. The research supports its use for gum disease and lice, though evidence for acne is still incomplete.
Is this safe to take if I have diabetes?
Neem may lower blood sugar, so if you take diabetes medication, combining them raises the risk of blood sugar dropping too low. Talk with your doctor or pharmacist before adding neem—they can help you decide whether it's safe and how to monitor yourself.
Can I use this while pregnant or breastfeeding?
No—the safety data advises against neem during pregnancy because it may affect fertility and pregnancy. There also isn't enough reliable safety information to use it while breastfeeding. Talk with your doctor or pharmacist if you're pregnant or planning to become pregnant.
What are the side effects of neem leaf extract?
In adults, neem extract is generally well tolerated. When applied to skin, the most common side effect is contact dermatitis (irritation) in people with sensitive skin. Serious side effects like heart or kidney problems are rare in adults but have been reported. In children, neem oil can cause serious problems, so this product should not be given to kids.
How does neem interact with my medications?
Neem leaf extract may slow how your body breaks down certain drugs, causing them to build up to higher levels and potentially cause stronger side effects. It may also weaken immunosuppressants and increase the risk of low blood sugar with diabetes medications. Check your specific medications with the search tool on this page.
Are there any fillers or additives in this product?
Besides neem leaf extract, the product contains glycerin and water as inactive ingredients. These help deliver and preserve the extract.

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

Not sure if Neem Alcohol Free is safe with your meds?

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Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Neem Alcohol Free label
Go deeper

The Full Monographs Behind Neem Alcohol Free’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Sources

Sources & How We Checked

Neem Alcohol Free's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 28 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Neem 28 references
  1. Sinniah D, Baskaran G. Margosa oil poisoning as a cause of Reye's syndrome. Lancet 1981;1:487-9. PubMed
  2. Sinniah D, Baskaran G, Looi LM, Leong KL. Reye-like syndrome due to margosa oil poisoning: report of a case with postmortem findings. Am J Gastroenterol 1982;77:158-61.
  3. Sinniah R, Sinniah D, Chia LS, Baskaran G. Animal model of margosa oil ingestion with Reye-like syndrome. Pathogenesis of microvesicular fatty liver. J Pathol 1989;159:255-64. PubMed
  4. Lai SM, Lim KW, Cheng HK. Margosa oil poisoning as a cause of toxic encephalopathy. Singapore Med J 1990;31:463-5.
  5. Biswas K, Chattopadhyay I, Banerjee RK, Bandyopadhyay U. Biological activities and medicinal properties of neem (Azadirachta indica). Curr Sci 2002;82:1336-45.
  6. Upadhyay SN, Dhawan S, Garg S, Talwar GP. Immunomodulatory effects of neem (Azadirachta indica) oil. Int J Immunopharmacol 1992;14:1187-93. PubMed
  7. Ibrahim IA, Khalid SA, Omer SA, Adam SE. On the toxicology of Azadirachta indica leaves. J Ethnopharmacol 1992;35:267-73. PubMed
  8. Ali BH. Toxicology of Azadirachta indica. J Ethnopharmacol 1994;42:71-2. PubMed
  9. Boeke SJ, Boersma MG, Alink GM, et al. Safety evaluation of neem (Azadirachta indica) derived pesticides. J Ethnopharmacol 2004;94:25-41. PubMed
  10. Abdel-Ghaffar, F. and Semmler, M. Efficacy of neem seed extract shampoo on head lice of naturally infected humans in Egypt. Parasitol.Res 2007;100(2):329-332. PubMed
  11. Reutemann, P. and Ehrlich, A. Neem oil: an herbal therapy for alopecia causes dermatitis. Dermatitis 2008;19(3):E12-E15.
  12. Senanayake, M. P., Rupasinghe, S., and Dissanayake, P. V. Margosa (Kohomba) oil induced toxic encephalopathy following home remedy for intestinal worms. Ceylon Med.J 2009;54(4):140. PubMed
  13. Bhaskar, M. V., Pramod, S. J., Jeevika, M. U., Chandan, P. K., and Shetteppa, G. MR imaging findings of neem oil poisoning. AJNR Am J Neuroradiol. 2010;31(7):E60-E61.
  14. Iyyadurai, R., Surekha, V., Sathyendra, S., Paul, Wilson B., and Gopinath, K. G. Azadirachtin poisoning: a case report. Clin Toxicol.(Phila) 2010;48(8):857-858. PubMed
  15. Sinniah, D., Sinniah, R., Baskaran, G., Pathmanathan, R., Yamashita, F., and Yoshino, M. Evaluation of the possible role of glucose, carnitine, coenzyme Q10 and steroids in the treatment of Reye's syndrome using the margosa oil animal model. Acta Paediat PubMed
  16. Balakrishnan, V., Pillai, N. R., and Santhakumari, G. Ventricular fibrillation and cardiac arrest due to neem leaf poisoning. J.Assoc.Physicians India 1986;34(7):536.
  17. Sivashanmugham, R., Bhaskar, N., and Banumathi, N. Ventricular fibrillation and cardiac arrest due to neem leaf poisoning. J.Assoc.Physicians India 1984;32(7):610-611.
  18. Mukherjee, S. and Talwar, G. P. Termination of pregnancy in rodents by oral administration of praneem, a purified neem seed extract. Am J Reprod.Immunol. 1996;35(1):51-56. PubMed
  19. Talwar, G. P., Pal, R., Singh, O., Garg, S., Taluja, V., Upadhyay, S. N., Gopalan, S., Jain, V., Kaur, J., and Sehgal, S. Safety of intrauterine administration of purified neem seed oil (Praneem Vilci) in women & effect of its co-administration with the
  20. Talwar, G. P., Shah, S., Mukherjee, S., and Chabra, R. Induced termination of pregnancy by purified extracts of Azadirachta Indica (Neem): mechanisms involved. Am J Reprod.Immunol. 1997;37(6):485-491. PubMed
  21. Greenblatt DT, Banerjee P, White JM. Allergic contact dermatitis caused by neem oil. Contact Dermatitis. 2012;67(4):242-3. PubMed
  22. Page C, Hawes EM. Haemolytic anaemia after ingestion of Neem (Azadirachta indica) tea. BMJ Case Rep. 2013. pii: bcr2013200890.
  23. Braidy N, Berg J, Clement J, et al. Role of nicotinamide dinucleotide and related precursors as therapeutic targets for age-related degenerative diseases: rationale, biochemistry, pharmacokinetics, and outcomes. Antiox Redox Signal 2018.
  24. Jadhav PB. Leucoderma on the lips induced by neem (Azadirachta indica): case series. Clin Exp Dermatol. 2018;43(8):943-6.
  25. Giuggioli D, Lumetti F, Spinella A, et al. Use of Neem oil and Hypericum perforatum for treatment of calcinosis-related skin ulcers in systemic sclerosis. J Int Med Res 2019:300060519882176. Online ahead of print.
  26. Pingali U, Ali MA, Gundagani S, Nutalapati C. Evaluation of the effect of an aqueous extract of Azadirachta indica (neem) leaves and twigs on glycemic control, endothelial dysfunction and systemic inflammation in subjects with type 2 diabetes mellitus - a
  27. 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
  28. 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

See these in context on the Neem monograph →

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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