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Dietary supplement

Neem Ingredients & Drug Interactions

by Herbal Terra

Neem label
See full label image
Liquid Category: Botanical
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 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 Herbal Terra 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 certified organic Neem (Azadirachta indica) dried leaf liquid 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 Herbal Terra

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

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HelloPharmacist Scorecard of Neem by Herbal Terra

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.

This product contains one active ingredient: certified organic neem (Azadirachta indica) dried leaf liquid extract. Neem is a traditional plant used in Ayurvedic and herbal medicine.

The liquid form means the dried leaf has been extracted and concentrated. The product also includes menstruum, an inactive ingredient used to prepare the extract.

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).

The evidence supports neem for a few uses. It's possibly effective for gingivitis (gum disease) and dental plaque when used topically, and possibly effective against lice.

For acne and tungiasis (a parasitic skin infection), the evidence we have isn't reliable enough to rate it either way. If you're considering neem for any condition, talk with your doctor about whether the evidence matches what you're hoping to treat.

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 appear well tolerated when taken by mouth in the short term, though high-quality safety data is limited. The biggest concern is that neem oil and seed extracts can be toxic if swallowed, so check the form you're using — this product is a leaf extract.

Topically, neem seems safe for both children and adults, though a small number of sensitive people have reported contact dermatitis. Serious side effects are rare but include cardiac issues and kidney damage with oral use in adults, and hemolysis (breaking down of red blood cells) has occurred, especially in people with G6PD deficiency.

Neem is not safe in pregnancy and should be avoided — it may affect fertility. There isn't enough safety data to recommend it while breastfeeding either.

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 neem product, check with your pharmacist or doctor if you take antidiabetes drugs like metformin — neem can lower blood sugar and raise the risk of hypoglycemia. Also double-check if you're on immunosuppressants or any medication metabolized through CYP1A2, CYP3A4, CYP2C9, CYP2C8 enzymes, or P-glycoprotein — neem may increase their levels.

These are common drug pathways, so a quick check of your exact medications is important.

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 may help with gum disease, plaque, and lice based on current evidence, but it interacts with a large number of medications — especially diabetes drugs and many others your liver processes. If you take any prescription medications, especially diabetes drugs, immunosuppressants, or anything for heart rhythm, check with your doctor or pharmacist before starting.

It's not safe in pregnancy or while breastfeeding.

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 Sep 25, 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 Herbal Terra
Barcode (UPC) 7429524228234
Net contents 4 Fluid Ounce(s); 120 mL
Market status On market
Date entered into DSLD Sep 25, 2020
DSLD ID 234026
Product type Botanical
Supplement form Liquid
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Organic, Gluten Free, Sugar 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 by Herbal Terra, 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 mL
Maximum serving Sizes:
1 mL
Servings per container
120
UPC/BARCODE
7429524228234
IngredientAmount% DV
certified organic Neem (Azadirachta indica) dried leaf liquid extract970 mg--

Other ingredients: Menstruum

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.
Formulation

Origin of plant material: India.

Manufactured in the USA in an FDA registered facility

Sugar free

Dried herb/menstruum ratio: 1:3 Expertly extracted Laboratory tested 330 mg/1 mL Premium product Super concentrated liquid herbal extract

Non GMO

No artificial ingredients, GMO, gluten, color additives, fillers, preservatives or binders. Natural Gluten Free

Suggested/Recommended/Usage/Directions

Direction Shake well before use. Adults take up to 30 drops (1 mL, one full squeeze of the dropper bulb) in 3-4 fl. oz of juice or water up to 4 times a day. We recommend to seek expert medical advice before taking this or any other herbal supplements.

FDA Disclaimer Statement

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

Precautions

Caution May have contraindications.

Do not use if you are allergic to any ingredients.

Consult a physician before using during pregnancy, if nursing, or if you are on any medications.

Keep out of the reach of children.

Storage

Store in a cool, dry, dark place.

Formula

Azadirachta indica

FDA Statement of Identity

Herbal Supplement

Seals/Symbols

Made in USA Made in an FDA registered facility Natural Gluten Free

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

See for yourself

Neem by Herbal Terra 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 Herbal Terra

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

Serving size1 mL Dosage formLiquid Servings per container120 Amounts shown are per serving.

Certified organic Neem (Azadirachta indica) dried leaf liquid extract

Interacts with
1,013 drugs
970 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...

Certified organic Neem (Azadirachta indica) dried leaf liquid extract monograph & interactions

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

Interaction report

Neem by Herbal Terra Drug Interactions

Want to check YOUR meds against Neem?

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

Ingredients driving the most interactions

certified organic Neem (Azadirachta indica) dried leaf liquid 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. certified organic Neem (Azadirachta indica) dried leaf liquid 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.

certified organic Neem (Azadirachta indica) dried leaf liquid 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
certified organic Neem (Azadirachta indica) dried leaf liquid extract full monograph & interactions
The maker

Brand information

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

Herbal Terra

See all Herbal Terra products
Name
Herbal Terra
Pharmacist Counseling Corner

Neem by Herbal Terra: Common Questions

Does Neem by Herbal Terra 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 while pregnant or breastfeeding?
No. Neem is rated likely unsafe in pregnancy because it may affect fertility and the developing baby. While breastfeeding, there isn't enough safety data, so it's best avoided. Talk with your doctor if you're pregnant, planning to become pregnant, or nursing.
Can I use neem on my skin, or just take it by mouth?
You can use neem topically — it seems well tolerated on the skin for both kids and adults, though some sensitive people have had contact dermatitis. Oral use (by mouth) is where most of the safety concerns come in, especially with neem oil and seed extracts. This product is a leaf extract, which is generally better tolerated orally short-term, but it still carries interaction and safety risks.
Does neem work for acne?
The evidence for acne isn't strong enough to say either way — we don't have reliable data on whether it actually works. You might see it recommended, but the research backing it up is thin.
What does neem do for gums and teeth?
Neem appears to help with gingivitis (inflamed gums) and dental plaque based on some clinical research. That's one of the uses with the best evidence behind it.
Can neem affect my blood sugar?
Yes. Some research shows neem can lower blood glucose levels, especially in people with type 2 diabetes. If you take diabetes medications, this is a serious concern — the combination could drop your blood sugar too low. Check with your doctor or pharmacist before using neem if you're on any diabetes drug.
What are the side effects of neem?
Taken by mouth, neem extracts are generally well tolerated in adults, though side effects haven't been studied thoroughly. Serious effects are rare but can include heart rhythm problems, kidney damage, and breakdown of red blood cells (particularly in people with a genetic condition called G6PD deficiency). On the skin, the main concern is contact dermatitis in sensitive people. Neem oil can be toxic in children if swallowed, so this liquid leaf extract is safer, but still needs caution.

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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