creatine (generic name)

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Interactions

Interactions with Drugs

In theory, creatine may alter the activities of insulin, particularly when taken with carbohydrates. Caution is advised when using medications that may also alter blood sugar levels. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary.

In theory, creatine may interact when taken in combination with acetaminophen/caffeine/CNS depressants, aspirin/caffeine/CNS depressants, or caffeine/ergotamine. It may interact with stimulants such as caffeine.

Use of creatine with probenecid may increase the levels of creatine in the body, leading to increased side effects.

Use of creatine with diuretics such as hydrochlorothiazide or furosemide (Lasix®) should be avoided because of the risks of dehydration and electrolyte disturbances. The likelihood of kidney damage may be greater when creatine is used with drugs that may damage the kidneys, such as trimethoprim, cimetidine (Tagamet®), anti-inflammatory drugs such as ibuprofen (Advil®, Motrin®), cyclosporine (Neoral®, Sandimmune®), amikacin, gentamicin or tobramycin.

It is possible that creatine may increase the cholesterol-lowering effects of other drugs commonly used to lower cholesterol levels, such as lovastatin (Mevacor®).

The combination of creatine and nonsteroidal anti-inflammatory drugs is more effective at reducing inflammation than either agent used alone.

Creatine and nifedipine, when used together, may enhance heart function, although research in this area is early.

In theory, creatine may also interact with aminoglycoside antibiotics, gallium nitrate, lansoprazole, sodium bicarbonate, tacrolimus, and valacyclovir.

Creatine supplements may enhance the activities and side effects of some cancer drugs.

Interactions with Herbs and Dietary Supplements

Creatine may increase the risk of adverse effects, including stroke, when used with caffeine and ephedra. In addition, caffeine may reduce the beneficial effects of creatine during intense intermittent exercise.

In theory, creatine may alter the activities of insulin. Caution is advised when using herbs or supplements that may also alter blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Creatine may reduce the effectiveness of vitamins A, D, E, and K.

Creatine may affect liver function, and should be used cautiously with potentially hepatotoxic (liver-damaging) or nephrotoxic (kidney damaging) herbs and supplements.

Use of creatine with diuretics should be avoided because of the risks of dehydration and electrolyte disturbances.

It is possible that creatine may increase the cholesterol-lowering effects of herbs and supplements that lower cholesterol levels, such as red yeast (Monascus purpureus).

In theory, creatine may interact with stimulants such as caffeine, which is found in green and black tea, or ephedra.

Creatine may interact with alpha-lipoic acid, arginine, hydroxymethylbutyrate, magnesium, pyruvate, and herbs and supplements broken down by the liver or kidneys. Creatine may also interact with anti-inflammatory and antineoplastic supplements.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Stefan Bughi, MD (University of Southern California); Jessica Clubb, PharmD (Northeastern University); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cynthia Dacey, PharmD (Natural Standard Research Collaboration); Theresa Davies-Heerema, PhD (Boston School of Medicine); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).

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