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Dietary supplement

Neem Ingredients & Drug Interactions

by Bixa Botanical

Neem label
See full label image
Capsule Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 30, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Neem against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Neem is a dietary supplement by Bixa Botanical 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 Azadirachta indica extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Neem by Bixa Botanical

Ask about any prescription or over-the-counter medication and we check it for interactions with Neem by Bixa Botanical — and tell you which ingredient is responsible.

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HelloPharmacist Scorecard of Neem by Bixa Botanical

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

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Aug 27, 2026

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 by Bixa Botanical is a single-ingredient supplement containing Azadirachta indica extract—the concentrated active compound from the neem tree leaf. The capsule itself is made from vegetarian cellulose (HPMC).

Neem leaf has been used traditionally for oral health, skin health, and immune support, though the strength of the evidence varies by use.

Does it work?

Not established
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
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use — see Neem's own graded uses on its monograph.

Why this rating?
  • The label markets this product for: blood and skin cleanser.
  • We looked for evidence on: Acne, Psoriasis, Wound healing, eczema, dermatitis.
  • The closest evidence on file: Neem is rated "Insufficient Reliable Evidence To Rate" for Acne (Natural Medicines).
  • Also on file: Neem is rated "Insufficient Reliable Evidence To Rate" for Psoriasis, Wound healing.

The research shows neem is possibly effective for gingivitis (inflamed gums), dental plaque, and head lice. For acne and tungiasis (a parasitic infection of the foot), the evidence is too limited or unreliable to rate it one way or the other.

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 preparations taken by mouth are generally well tolerated in adults over the short term, though formal safety studies are limited. However, neem oil and concentrated seed extracts can be toxic if swallowed, especially in children—serious effects in young children have been reported with neem oil.

Topically, neem appears well tolerated. Neem should be avoided in pregnancy because it may affect fertility and the developing baby.

It should also be avoided while breastfeeding due to insufficient safety data. Rare serious effects reported with oral neem include cardiac arrhythmias (irregular heartbeat), kidney damage, and in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency, a type of anemia called hemolysis.

Topically, contact dermatitis can occur in sensitive individuals.

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 neem, check with your doctor or pharmacist if you take diabetes medications (metformin or other glucose-lowering drugs), immunosuppressants, or any drug broken down by your liver through the CYP1A2, CYP2C8, CYP2C9, or CYP3A4 enzyme systems, or that depends on P-glycoprotein transport—examples include many statins, blood pressure drugs, and antihistamines. Lab research suggests neem may increase the levels of these drugs, but human evidence is limited.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Moderate medication interactions have been identified, and safety information is well characterized.

Neem may be worth considering if you're looking into natural support for gum inflammation, dental plaque, or lice, and you take no medications that interact with it. If you take any prescription or over-the-counter drugs—especially diabetes medications, immune suppressants, or anything metabolized by your liver—you'll need to check first with your doctor or pharmacist.

Pregnant people and those breastfeeding should avoid it altogether.

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 Jun 24, 2020.

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, straight from the product label.

Brand Bixa Botanical
Barcode (UPC) X001ATVH9J
Net contents 60 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Jun 24, 2020
DSLD ID 228919
Product type Botanical
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), Kosher, Women (not pregnant or lactating), Halal
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 by Bixa Botanical, 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:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
60
UPC/BARCODE
X001ATVH9J
IngredientAmount% DV
Azadirachta indica extract450 mg--

Other ingredients: HPMC Vegetarian Capsule

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.
Precautions

Warning: This product is not intended for use by those with serious medical condition or pregnant or lactating women. Consult your physician before use.

Keep out of reach of children.

Do not use if seal is broken.

FDA Disclaimer Statement

Disclaimer: These statements have not been evaluated by the Food and Drug Administration and this product is a food supplement and not intended to diagnose treat or cure or prevent any disease.

Seals/Symbols

Halal Mumbai India Halal Committee Registration No. 0854 K LBD (Kosher) Good manufacturing practices GMP

Formulation

Vegan

Blood & skin cleanser

Formula

K LBD (Kosher)

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Suggested use: 1 capsules 2 times daily before food or as directed by physician

Storage

Store in a cool and dry place.

General Statements

Neutral code: MP/25D/9/89

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Neem by Bixa Botanical label

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

Neem label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Neem by Bixa Botanical

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

Serving size1 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

Azadirachta indica extract

Interacts with
1,013 drugs
450 mg per serving Form: Bitters

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

Azadirachta indica extract monograph & interactions

Other (inactive) ingredients: HPMC Vegetarian Capsule. These complete the product’s ingredient list but are not active constituents.

Interaction report

Neem by Bixa Botanical Drug Interactions

Want to check YOUR meds against Neem?

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

Azadirachta indica extract 1,013

Individual Drug Interactions

The ingredients in Neem interact with 1,013 drugs. Click any drug to see the details.

1 of the 1 ingredient in Neem interact with drugs. Each result below shows which ingredient is responsible. Azadirachta indica extract

Each ingredient & the kinds of drugs it affects

For each ingredient in Neem 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.

Azadirachta indica extract7 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
Azadirachta indica extract full monograph & interactions
The maker

Brand information

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

Bixa Botanical

See all Bixa Botanical products
Name
Jairamdass Khushiram
Street Address
Plot No - M -14/14-1, MIDC, Taloja
City
410 208 Maharasthra
Phone Number
00-91-22-2783 1232
Web Address
www.bixabotanical.com
Pharmacist Counseling Corner

Neem by Bixa Botanical: Common Questions

Does Neem by Bixa Botanical interact with any medications?
Yes. Based on its ingredients, Neem 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 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.
Is neem safe to use if I have type 2 diabetes and take metformin?
Neem may lower blood glucose levels on its own, and some clinical research shows it can do this even in people already on metformin. This raises the risk of low blood sugar (hypoglycemia). You should talk with your doctor or pharmacist before starting neem to see if your glucose and medication need adjusting.
Can I use neem if I'm pregnant or breastfeeding?
No—neem should be avoided in pregnancy because it may affect fertility and the developing baby. There's also not enough safety information for breastfeeding, so it's best avoided then too. If you're pregnant or nursing, talk with your doctor about whether neem is right for you.
Does neem really work for gingivitis and plaque?
Neem is possibly effective for both gingivitis (inflamed gums) and dental plaque based on the research we have. That means there's some evidence it helps, but more studies would strengthen what we know.
What's the most common side effect if I take neem by mouth?
Oral neem extract appears generally well tolerated in adults, though serious formal safety studies are limited. Rare serious effects—like irregular heartbeat or kidney problems—have been reported, especially with neem oil rather than leaf extract.
Can I give neem to my child?
Oral neem oil can cause serious harm in children and should not be used. Neem leaf extract appears better tolerated, but you should check with your pediatrician before giving it.
Will neem interfere with my immune-suppressing medication after my transplant?
Animal research suggests neem may have immunostimulant effects that could theoretically reduce how well your immunosuppressant works. Before taking neem, talk with your transplant team or doctor to make sure it won't interfere with your care.

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

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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 label
Go deeper

The Full Monographs Behind Neem’s Ingredients

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

Herb & supplement monograph

Neem

Interacts with 1,013 drugs

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...

Read the full Neem monograph →
Sources

Sources & How We Checked

Neem'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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