Creatine

Creatine is used in alternative medicine as a possibly effective way to enhance athletic performance and increase muscle strength in people with heart failure, muscular dystrophy, and McArdle's disease (a genetic disorder). It may also be possibly effective for treating Parkinson's disease and gyrate atrophy (a genetic eye disorder that affects the retina and causes vision loss).

Creatine has been used to treat rheumatoid arthritis and Lou Gehrig's disease (ALS). However, research has shown that it may not be effective for these conditions.

Other unproven uses include treating high cholesterol, depression, bipolar disorder, or certain muscle diseases.

It is not clear whether creatine is effective for any medical condition. The medicinal use of this product has not been approved by the FDA. It should not be used instead of medication prescribed by your doctor.

Creatine is often sold as an herbal supplement. There are no regulated manufacturing standards for many herbal products, and some supplements on the market have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be bought from a reliable source to reduce the risk of contamination.

When thinking about using herbal supplements, ask your doctor for advice. You might also want to consult someone who is trained in herbal or health supplements.

If you decide to use creatine, follow the instructions on the package or the guidance from your doctor, pharmacist, or another healthcare provider. Do not use more of this product than what is recommended on the label. High doses may harm your heart, kidneys, or liver.

Some athletes have used a "loading method" by taking large doses for 2 to 5 days, followed by smaller "maintenance" doses. This method is used by athletes who want a short-term boost in athletic performance, like before a competition.

Another method is to take smaller doses over a longer training period. This method is used by people looking for endurance during long-term training, such as bodybuilding.

Creatine may work better if you take it with a meal that contains carbohydrates. Always follow the directions on the product label.

Muscle tissues can only store a limited amount of creatine. Using more of this product will not increase its effects.

Do not take different forms (tablets, liquid, powder, beverages, etc.) of creatine at the same time without medical advice. Taking different types together raises the risk of overdose.

Drink plenty of fluids to avoid overheating or dehydration during exercise and in hot weather. You may be at greater risk of dehydration, heat stroke, or electrolyte imbalances while taking creatine.

Store in a sealed container as directed on the label, away from moisture and heat.

Creatine has not been checked by the FDA for safety, effectiveness, or purity. Not all possible risks and benefits of this medication may be known. There are also no official manufacturing standards for these products. Some herbal/health supplements have been found to be contaminated with harmful metals or other drugs. Herbal/health supplements should be bought from a trusted source to reduce the risk of contamination.

Drink plenty of fluids while taking creatine. While it has not been proven, dehydration, heat-related illnesses, muscle cramps, reduced blood volume, and electrolyte imbalances may be more likely to happen while taking creatine.

Follow all instructions on the product label and package. Inform each of your healthcare providers about all your medical conditions, allergies, and all medications you are using.

You should not use creatine if you have:

• kidney disease; or
• diabetes.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

• heart disease.

Creatine may not work as well to improve strength or build muscle in people over 60 years old.

It is not known whether creatine will harm an unborn baby. Do not use this product if you are pregnant.

Creatine may pass into breast milk and may harm a nursing baby. Do not use this product if you are breast-feeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

Get emergency medical help if you have any of these signs of an allergic reaction to creatine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using creatine and call your healthcare provider at once if you have:

• pounding heartbeats or fluttering in your chest;
• trouble breathing;
• swelling, rapid weight gain;
• dehydration symptoms--feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin; or
• signs of an electrolyte imbalance--dry mouth, increased thirst, drowsiness, restless feeling, confusion, nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, fainting, or seizure (convulsions).

Common creatine side effects may include:

• nausea, stomach pain;
• diarrhea;
• muscle cramps; or
• weight gain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Skip the missed dose if it is nearly time for your next dose. Do not take any extra to compensate for the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Creatine can cause kidney damage when used for a long time or if you take too much each day.

Avoid drinking caffeine (coffee, tea, soda) or using herbal stimulants like ephedra or Ma Huang while you are taking creatine. Mixing this product with these substances may increase your risk of having a stroke or other serious medical issues.

Avoid getting overheated or dehydrated during exercise and in hot weather.

Creatine can harm your kidneys. This risk is higher if you also take certain other medicines, such as:

• antivirals, injected antibiotics;
• chemotherapy;
• medicine for bowel disorders;
• medicine to prevent organ transplant rejection;
• injectable osteoporosis medication; and
• some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

This list is not complete. Other drugs may interact with creatine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.