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.



