NEEM

OTHER NAME(S):

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

Overview Information

Neem is a tree. The bark, leaves, and seeds are used to make medicine. Less often, the root, flower, and fruit are also used.

Neem leaf is used for leprosy, eye disorders, bloody nose, intestinal worms, stomach upset, loss of appetite, skin ulcers, diseases of the heart and blood vessels (cardiovascular disease), fever, diabetes, gum disease (gingivitis), and liver problems. The leaf is also used for birth control and to cause abortions.

The bark is used for malaria, stomach and intestinal ulcers, skin diseases, pain, and fever.

The flower is used for reducing bile, controlling phlegm, and treating intestinal worms.

The fruit is used for hemorrhoids, intestinal worms, urinary tract disorders, bloody nose, phlegm, eye disorders, diabetes, wounds, and leprosy.

Neem twigs are used for cough, asthma, hemorrhoids, intestinal worms, low sperm levels, urinary disorders, and diabetes. People in the tropics sometimes chew neem twigs instead of using toothbrushes, but this can cause illness; neem twigs are often contaminated with fungi within 2 weeks of harvest and should be avoided.

The seed and seed oil are used for leprosy and intestinal worms. They are also used for birth control and to cause abortions.

The stem, root bark, and fruit are used as a tonic and astringent.

Some people apply neem directly to the skin to treat head lice, skin diseases, wounds, and skin ulcers; as a mosquito repellent; and as a skin softener.

Inside the vagina, neem is used for birth control.

Neem is also used as an insecticide.

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

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. Also, 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.
  • Birth control.
  • Breathing conditions.
  • Diabetes.
  • Fever.
  • Heart disease.
  • Indigestion (dyspepsia).
  • Infection of the intestines by parasites.
  • Malaria.
  • Skin conditions and diseases.
  • Other conditions.
More evidence is needed to rate the effectiveness of neem for these uses.

Side Effects

Side Effects & Safety

When 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:

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 or 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.

Pregnancy and breast-feeding: Neem oil and neem bark are LIKELY UNSAFE when taken by mouth during pregnancy. They can cause a miscarriage.

Not enough is known about the safety of neem during breast-feeding. Stay on the safe side and avoid use.

"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.

Interactions

Interactions?

Moderate Interaction

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.

Dosing

Dosing

The following doses have been studied in scientific research:

ADULTS

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.
CHILDREN

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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View References

REFERENCES:

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  • Environmental Protection Agency. Azadirachtin (121701) Clarified Hydrophobic Extract of Neem Oil (025007) Fact Sheet. Available at: http://www.epa.gov/pesticides/biopesticides/ingredients/ factsheets/factsheet_025007.htm.(Accessed 9 March 2005).
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  • Sam-Wobo, S. O., Adeleke, M. A., Mafiana, C. F., and Surakat, O. H. Comparative repellent activities of some plant extracts against Simulium damnosum complex. Vector.Borne.Zoonotic.Dis. 2011;11(8):1201-1204. View abstract.
  • 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.
  • Semmler, M., Abdel-Ghaffar, F., Al-Rasheid, K., and Mehlhorn, H. Nature helps: from research to products against blood-sucking arthropods. Parasitol.Res 2009;105(6):1483-1487. View abstract.
  • 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. View abstract.
  • Sharma, S. K., Dua, V. K., and Sharma, V. P. Field studies on the mosquito repellent action of neem oil. Southeast Asian J.Trop.Med.Public Health 1995;26(1):180-182. View abstract.
  • Sharma, S., Saimbi, C. S., Koirala, B., and Shukla, R. Effect of various mouthwashes on the levels of interleukin-2 and interferon-gamma in chronic gingivitis. J Clin Pediatr.Dent. 2008;32(2):111-114. View abstract.
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  • 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. View abstract.
  • Sundaravalli, N., Raju, B. B., and Krishnamoorthy, K. A. Neem oil poisoning. Indian J.Pediatr. 1982;49(398):357-359. View abstract.
  • 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 heterospecies dimer birth control vaccine on antibody response to human chorionic gonadotropin. Indian J.Med.Res. 1995;102:66-70. View abstract.
  • 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.
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  • 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.
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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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  • Semmler M, Abdel-Ghaffar F, Gestmann F, et al. Randomized, investigator-blinded, controlled clinical study with lice shampoo (Licener®) versus dimethicone (Jacutin® Pedicul Fluid) for the treatment of infestations with head lice. Parasitol Res 2017;116(7):1863-70. View abstract.
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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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