Azadirachta indica (generic name)

treats Psoriasis vulgaris, Ulcers, Dental plaque, and Mosquito repellent
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Interactions

Interactions with Drugs

Concomitant use of acetaminophen (Tylenol®) and neem leaf extract may cause liver toxicity. Caution is advised in patients taking other agents that may cause liver toxicity.

Due to possible hypotensive (blood pressure lowering) effects, neem should be used cautiously with other hypotensive agents.

Neem leaf extract may inhibit the clastogenic activity of cyclophosphamide (Cytoxan®) and mitomycin C. Patients taking chemotherapy agents should use neem with caution.

Neem may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. Neem had synergistic activity with dillapiol, a cytochrome P450 3A4 inhibitor. Theoretically, neem may have synergistic activity with other cytochrome P450 3A4 inhibitors. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

The combination of a low dose of neem leaf extract and a low dose of morphine produced an increased loss of pain sensation. Theoretically, neem and some opiate analgesics (pain relievers) may work together (synergistically) for a positive interaction, although a qualified healthcare professional, including a pharmacist should be consulted before combining therapies.

Neem may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

The use of neem extract and quinine hydrochloride has been reported to have positive (synergistic) effects in the spermicidal activity of these agents. Quinines are often used in the treatment of malaria.

Interactions with Herbs and Dietary Supplements

Neem may lower blood sugar levels. Caution is advised in patients with diabetes (high blood sugar) or hypoglycemia (low blood sugar), and in those taking herbs or supplements that may also lower blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary. Blood glucose levels may require monitoring, and doses may need adjustment.

Neem may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. Neem had synergistic activity with dillapiol, a cytochrome P450 3A4 inhibitor. Theoretically, neem may have synergistic activity with other cytochrome P450 3A4 inhibitors. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Administration of garlic and neem leaf extracts may decrease the formation of lipid peroxides and enhance the levels of antioxidants and detoxifying enzymes in stomach, as well as in the liver and circulation.

Due to possible hypotensive (blood pressure lowering) effects, neem should be used cautiously with other hypotensive herbs and supplements.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Abrams, PharmD (University of Rhode Island); Heather Boon BScPhm, PhD (University of Toronto); Cathy DeFranco Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Karta Purkh Singh Khalsa, CDN, RH (University of Texas); Phuong Ngo, PharmD (Massachusetts General Hospital); Erica Seamon, PharmD (Nova Southeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Northeastern University).

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