Creatine : Interactions with Drugs and Dietary Supplements

by MedlinePlus

(Page 3 of 3)

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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.

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®).

Animal studies report that the combination of creatine and non-steroidal 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.

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. Possible examples of herbs and supplements that may cause hypoglycemia include Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), maitake mushroom, marshmallow, milk thistle, Panax ginseng, rosemary, shark cartilage, Siberian ginseng, stinging nettle and white horehound. Agents that may raise blood sugar levels include arginine, cocoa, and ephedra (when combined with caffeine).

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) herbs and supplements, such as ackee, bee pollen, birch oil, blessed thistle, borage, bush tea, butterbur, chaparral, coltsfoot, comfrey, DHEA, Echinacea purpurea , Echium spp., germander, Heliotropium spp., horse chestnut (parenteral preparations), Jin-bu-huan (Lycopodium serratum), kava, lobelia, L-tetrahydropalmatine (THP), mate, niacin (vitamin B-3), niacinamide, Paraguay tea, periwinkle, Plantago lanceolata , pride of Madeira, rue, sassafras, scullcap, Senecio spp./groundsel, tansy ragwort, turmeric/curcumin, Tu-san-chi (Gynura segetum), uva ursi, valerian, and white chameleon.

Use of creatine with diuretics should be avoided because of the risks of dehydration and electrolyte disturbances. Herbs with possible diuretic effects include artichoke, celery, corn silk, couchgrass, dandelion, elder flower, horsetail, juniper berry, kava, shepherd's purse, uva ursi, and yarrow.

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 ).

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