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Neem (Azadirachta indica)



Interactions

Neem/Drug Interactions:
  • AcetaminophenAcetaminophen: Concomitant use of acetaminophen and aqueous leaf extract of Azadirachta indica has been reported to induce hepatotoxicity in rats (38).
  • Antidiabetic agentsAntidiabetic agents: Based on animal study, neem may decrease glucose levels and caution is advised when using concomitantly with other sugar-altering herbs and supplements (23).
  • Antihypertensive drugsAntihypertensive drugs: Due to possible hypotensive effects, neem should be used cautiously with other hypotensive agents (22).
  • Cyclophosphamide and mitomycin CCyclophosphamide and mitomycin C: Neem leaf extract may inhibit the clastogenic activity of cyclophosphamide and mitomycin C (39).
  • Cytochrome P450 metabolized agentsCytochrome P450 metabolized agents: Neem had synergistic activity with dillapiol, a cytochrome P450 3A4 inhibitor (40). Theoretically, neem may have synergistic activity with other cytochrome P450 3A4 inhibitors.
  • MorphineMorphine: The combination of a low dose of neem leaf extract (3.12mg/kg) and a low dose of morphine (0.5mg/kg) produced an increased loss of pain sensation (41).
  • QuinineQuinine: Concomitant use of neem extract and quinine hydrochloride has been reported to have positive synergistic effect in the spermicidal activity of these agents (42).

Neem/Herb/Supplement Interactions:
  • Cytochrome P450 metabolized herbs and supplementsCytochrome P450 metabolized herbs and supplements: Neem had synergistic activity with dillapiol, a cytochrome P450 3A4 inhibitor (40). Theoretically, neem may have synergistic activity with other cytochrome P450 3A4 inhibitors.
  • GarlicGarlic: Administration of garlic and neem leaf extracts significantly decreased the formation of lipid peroxides and enhanced the levels of antioxidants and detoxifying enzymes in stomach, as well as in the liver and circulation (43).
  • HypoglycemicsHypoglycemics: Based on animal study, neem may decrease glucose levels and caution is advised when using concomitantly with other sugar-altering herbs and supplements (23).
  • HypotensivesHypotensives: Due to possible hypotensive effects, neem should be used cautiously with other hypotensive herbs and supplements (22).

Neem/Food Interactions:
  • Insufficient available evidence.

Neem/Lab Interactions:
  • AmmoniaAmmonia: Significant increases in ammonia were observed in rats treated with 5mL/kg neem oil (margosa oil) intraperitoneally. Ammonia levels increased from 367+/-89mcg NH3N/dL to 716+/-167mcg NH3N/dL (p<0.02 compared to corn oil control and nonsignificant compared to baseline) (23).
  • Bilirubin, potassium, testosteroneBilirubin, potassium, testosterone: Oral administration of crude aqueous neem extract resulted in significant decreases in total bilirubin, serum potassium, and testosterone in rats (26).
  • GlucoseGlucose: Based on animal study, neem may decrease glucose levels. Glucose levels were decreased in rats from 128+/-3mg/dL to 73+/-7mg/dL (p<0.001 compared to corn oil control and p<0.01 compared to baseline) (23).
  • Hemoglobin, lymphocytes, mean corpuscular hemoglobin concentration (MCHC), red blood cells (RBC), white blood cell (WBC)Hemoglobin, lymphocytes, mean corpuscular hemoglobin concentration (MCHC), red blood cells (RBC), white blood cell (WBC): Oral administration of crude aqueous neem extract resulted in significant increases in hemoglobin, lymphocytes, MCHC, RBCs, and WBCs in rats (26).
  • Thyroid functionThyroid function: High concentrations of neem leaf extract may be inhibitory to thyroid function, particularly conversion of T3 and T4 (24). High doses decreased T3 and increased T4 concentrations in rats following 100mg/kg per day for 20 days of neem leaf extract.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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