Antelaea azadirachta, Arishta, Arishtha, Azadirachta indica, Bead Tree, Holy Tree, Huile de Neem, Indian Lilac, Indian Neem, Lilas des Indes, Lilas de Perse, Margosa, Margosa Tree, Margousier, Margousier à Feuilles de Frêne, Margousier d'Inde, Melia azadirachta, Neem Oil, Neem Tree, Melia azadirachta, Nim, Nimb, Nimba, Persian Lilac, Pride of China.
Overview InformationNeem is a tree. It grows in tropical regions such as India and Myanmar. The bark, leaves, and seeds are used to make medicine. Less often, the root, flower, and fruit are also used.
Neem is used for tooth plaque, gum disease (gingivitis), lice, to repel insects, and for other conditions, but there is no good scientific evidence to support most of these uses.
How does it work?Neem contains chemicals that might help reduce blood sugar levels, heal ulcers in the digestive tract, prevent pregnancy, kill bacteria, and prevent plaque formation in the mouth.
Uses & Effectiveness
Possibly Effective for
- Tooth plaque. Most research shows that applying a gel containing neem leaf extract to the teeth or using a neem mouthwash can reduce the amount of plaque on the teeth. But it might not be as helpful as using chlorhexidine mouthwash.
- A mild form of gum disease (gingivitis). Most research shows that applying a gel containing neem leaf extract or using a neem mouthwash can reduce gingivitis in some people, but it doesn't seem to be as helpful as chlorhexidine mouthwash and it may not be effective for people with long-standing gingivitis.
- Lice. Clinical research shows that applying a neem extract shampoo to the scalp once completely cures head lice in children.
Insufficient Evidence for
- Insect repellent. Early research shows that applying extract of neem root or leaf to the skin helps repel black flies.
- Mosquito repellent. Early research shows that applying neem oil cream to the skin seems to protect against some types of mosquitos.
- Stomach ulcers. Early research suggests that taking neem bark extract by mouth for 10 weeks might help heal ulcers in the stomach and intestines.
- Scaly, itchy skin (psoriasis). Early research suggests that taking neem extract by mouth for 12 weeks, along with daily sun exposure and the application of a coal tar and salicylic acid cream, might make the symptoms of psoriasis less severe.
- An eating disorder (anorexia nervosa).
- Birth control.
- Eye disorders.
- Heart disease.
- Indigestion (dyspepsia).
- Infection of the intestines by parasites.
- Liver disease.
- Wound healing.
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Neem bark extract is POSSIBLY SAFE for most adults when taken by mouth, short-term. Doses of up to 60 mg daily for up to 10 weeks have been safely used in humans. Neem is POSSIBLY UNSAFE when taken by mouth in large doses or for long periods of time. It might harm the kidneys and liver.
When applied to the skin: Neem leaf extract gel is POSSIBLY SAFE when applied inside the mouth for up to 6 weeks. Neem oil or cream is POSSIBLY SAFE when applied to the skin for up to 2 weeks.
Special Precautions & Warnings:Pregnancy: Neem oil and neem bark are LIKELY UNSAFE when taken by mouth during pregnancy. They can cause a miscarriage.
Breast-feeding: There isn't enough reliable information to know if neem is safe to use when breast-feeding. Stay on the safe side and avoid use.
Children: Neem extract shampoo is LIKELY SAFE in children when applied once or twice to the head for 10 minutes then rinsed with warm water. Neem seeds and seed oil are LIKELY UNSAFE when taken by mouth in children. Serious side effects in infants and small children can happen within hours after taking neem oil. These serious side effects include vomiting, diarrhea, drowsiness, blood disorders, seizures, loss of consciousness, coma, brain disorders, and death.
"Auto-immune diseases" such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Neem might cause the immune system to become more active. This could increase the symptoms of auto-immune diseases. If you have one of these conditions, it's best to avoid using neem.
Diabetes: There is some evidence that neem can lower blood sugar levels and might cause blood sugar to go too low. If you have diabetes and use neem, monitor your blood sugar carefully. It might be necessary to change the dose of your diabetes medication.
Reduced ability to have children (infertility): There is some evidence that neem can harm sperm. It might also reduce fertility in other ways. If you are trying to have children, avoid using neem.
Organ transplant: There is a concern that neem might decrease the effectiveness of medications that are used to prevent organ rejection. Do not use neem if you have had an organ transplant.
Surgery: Neem might lower blood sugar levels. There is a concern that it might interfere with blood sugar control during and after surgery. Stop using neem at least 2 weeks before a scheduled surgery.
Be cautious with this combination
Lithium interacts with NEEM
Neem might have an effect like a water pill or "diuretic." Taking neem might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.
Medications for diabetes (Antidiabetes drugs) interacts with NEEM
Neem might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking neem along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications that decrease the immune system (Immunosuppressants) interacts with NEEM
Neem might increase the immune system. By increasing the immune system, neem might decrease the effectiveness of medications that decrease the immune system.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
The following doses have been studied in scientific research:
APPLIED TO THE SKIN:
- For a mild form of gum disease (gingivitis): A neem leaf extract gel has been applied to the teeth and gums twice daily for 6 weeks. 15 mL of 2% neem solution used as a mouthwash for 30 seconds after brushing daily for 3 weeks.
- For tooth plaque: A neem leaf extract gel has been applied to the teeth and gums twice daily for 6 weeks. 15 mL of 2% neem solution used as a mouthwash for 30 seconds after brushing daily for 3 weeks. 5 mL of neem solution used as a mouthwash twice daily for 30 days.
APPLIED TO THE SKIN:
- For lice: 100 mL of a specific neem extract shampoo (Licener, Pronovo Laboratories) applied to dry hair for 10 minutes then rinsed with warm water once or repeated for a second application.
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- Jalaluddin M, Rajasekaran UB, Paul S, Dhanya RS, Sudeep CB, Adarsh VJ. Comparative evaluation of neem mouthwash on plaque and gingivitis: a double-blind crossover study. J Contemp Dent Pract 2017;18(7):567-71. View abstract.
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- Schmahl, G., Al-Rasheid, K. A., Abdel-Ghaffar, F., Klimpel, S., and Mehlhorn, H. The efficacy of neem seed extracts (Tre-san, MiteStop on a broad spectrum of pests and parasites. Parasitol.Res 2010;107(2):261-269. View abstract.
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- 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. View abstract.
- Trost, L. C. and Lemasters, J. J. The mitochondrial permeability transition: a new pathophysiological mechanism for Reye's syndrome and toxic liver injury. J Pharmacol Exp Ther 1996;278(3):1000-1005. View abstract.
- Vanka, A., Tandon, S., Rao, S. R., Udupa, N., and Ramkumar, P. The effect of indigenous Neem Azadirachta indica [correction of (Adirachta indica)] mouth wash on Streptococcus mutans and lactobacilli growth. Indian J.Dent.Res. 2001;12(3):133-144. View abstract.
- Verma, S. P. HIV: a raft-targeting approach for prevention and therapy using plant-derived compounds (review). Curr Drug Targets. 2009;10(1):51-59. View abstract.
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- Aladakatti RH, Ahamed RN. Effect of Azadirachta indica leaves on rat spermatozoa. Indian J Exp Biol 1999;37:1251-4. View abstract.
- Ali BH. Toxicology of Azadirachta indica. J Ethnopharmacol 1994;42:71-2. View abstract.
- Balappanavar AY, Sardana V, Singh M. Comparison of the effectiveness of 0.5% tea, 2% neem and 0.2% chlorhexidine mouthwashes on oral health: a randomized control trial. Indian J Dent Res. 2013;24(1):26-34. View abstract.
- Bandyopadhyay U, Biswas K, Sengupta A, et al. Clinical studies on the effect of Neem (Azadirachta indica) bark extract on gastric secretion and gastroduodenal ulcer. Life Sci 2004;75:2867-78. View abstract.
- Bhanwra S, Singh J, Khosla P. Effect of Azadirachta indica (Neem) leaf aqueous extract on paracetamol-induced liver damage in rats. Indian J Physiol Pharmacol 2000;44:64-8. View abstract.
- Biswas K, Chattopadhyay I, Banerjee RK, Bandyopadhyay U. Biological activities and medicinal properties of neem (Azadirachta indica). Curr Sci 2002;82:1336-45.
- Boeke SJ, Boersma MG, Alink GM, et al. Safety evaluation of neem (Azadirachta indica) derived pesticides. J Ethnopharmacol 2004;94:25-41. View abstract.
- Chattopadhyay RR, Sarkar SK, Ganguly S, et al. Hepatoprotective activity of Azadirachta indica leaves on paracetamol induced hepatic damage in rats. Indian J Exp Biol 1992;30:738-40. View abstract.
- Chinnasamy N, Harishankar N, Kumar PU, Rukmini C. Toxicological studies on debitterized Neem oil (Azadirachta indica). Food Chem Toxicol 1993;31:297-301. View abstract.
- Environmental Protection Agency. Azadirachtin (121701) Clarified Hydrophobic Extract of Neem Oil (025007) Fact Sheet. Available at: https://www.epa.gov/pesticides/biopesticides/ingredients/ factsheets/factsheet_025007.htm.(Accessed 9 March 2005).
- 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. View abstract.
- 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. View abstract.
- Balappanavar, A. Y., Nagesh, L., Ankola, A. V., Tangade, P. S., Kakodkar, P., and Varun, S. Antimicrobial efficacy of various disinfecting solutions in reducing the contamination of the toothbrush -- a comparative study. Oral Health Prev.Dent. 2009;7(2):137-145. View abstract.
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- 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. View abstract.
- Dua, V. K., Nagpal, B. N., and Sharma, V. P. Repellent action of neem cream against mosquitoes. Indian J.Malariol. 1995;32(2):47-53. View abstract.
- Gandhi, M., Lal, R., Sankaranarayanan, A., Banerjee, C. K., and Sharma, P. L. Acute toxicity study of the oil from Azadirachta indica seed (neem oil). J Ethnopharmacol 1988;23(1):39-51. View abstract.
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- Jones, I. W., Denholm, A. A., Ley, S. V., Lovell, H., Wood, A., and Sinden, R. E. Sexual development of malaria parasites is inhibited in vitro by the neem extract azadirachtin, and its semi-synthetic analogues. FEMS Microbiol.Lett. 7-15-1994;120(3):267-273. View abstract.
- Kant, R. and Bhatt, R. M. Field evaluation of mosquito repellent action of neem oil. Indian J.Malariol. 1994;31(3):122-125. View abstract.
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- Koley, K. M. and Lal, J. Pharmacological effects of Azadirachta indica (neem) leaf extract on the ECG and blood pressure of rat. Indian J Physiol Pharmacol 1994;38(3):223-225. View abstract.
- Mbah, A. U., Udeinya, I. J., Shu, E. N., Chijioke, C. P., Nubila, T., Udeinya, F., Muobuike, A., Mmuobieri, A., and Obioma, M. S. Fractionated neem leaf extract is safe and increases CD4+ cell levels in HIV/AIDS patients. Am J Ther 2007;14(4):369-374. View abstract.
- 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. View abstract.
- Pai, M. R., Acharya, L. D., and Udupa, N. The effect of two different dental gels and a mouthwash on plaque and gingival scores: a six-week clinical study. Int.Dent.J 2004;54(4):219-223. View abstract.
- Pandey, S., Jha, A., and Kaur, V. Aqueous extract of neem leaves in treatment of psoriasis vulgaris. Indian Journal of Dermatol Venereol Leprol 1994;60(2):63-67.
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