creatine

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Enhancement of exercise performance
Increasing muscle mass
HF
Parkinson's disease
Muscular dystrophy

Action ⬆ ⬇

Creatine increases muscle cell water retention causing muscle enlargement. Creatine increases ATP levels leading to increased energy bursts and improved recovery from intense exercise.

Therapeutic effects:

Enhanced exercise performance.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Metabolized to creatinine and excreted renally.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	Unknown	Unknown	Unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Allergy to creatine;
OB: Pregnancy and lactation.

Use Cautiously in:

Renal dysfunction;
Liver disease;
Diabetes.

Adv. Reactions/Side Effects ⬆ ⬇

CV: arrhythmia, lower extremity deep vein thrombosis

Derm: rash

F and E: dehydration

GI: abdominal pain, diarrhea, nausea

GU: Increased serum creatinine , altered liver function, nephrotoxicity

MS: muscle cramps

Resp: shortness of breath

Misc: compartment syndrome, weight gain

Interactions ⬆ ⬇

Natural-Drug Products:

May ↑ risk of nephrotoxicity with nephrotoxic drugs includingaminoglycosides NSAIDsand cyclosporine.
↑risk of dehydration when used withdiuretics.
May interfere with effects of antidiabetic agents.

Natural-Natural Products:

May ↑ risk of ischemic stroke when taken with caffeine.

Route/Dosage ⬆ ⬇

PO (Adults ): Physical performance: Loading dose: 20 grams per day (or 0.3 grams/kg) x 5 days followed by a maintenance dose of 2 grams (or 0.03 grams/kg) daily; HF: 20 grams/day x 5–10 days; Parkinson's disease: 10 grams/day; Muscular dystrophy in children: 5 grams/day.

Availability ⬆ ⬇

Powder: ^OTC
Capsules: ^OTC
Liquid: ^OTC

Assessment ⬆ ⬇

Monitor exercise performance prior to and periodically during therapy.

Lab Test Considerations:

Monitor serum albumin, ammonia, AST, cortisol, creatine kinase, creatinine, electrolytes, glucagon, glycogen, guanidine compounds, homocysteine, hypoxanthine, insulin, LDH, lipid panel, liver function tests, renal function tests, CBC and urinary creatine periodically during therapy.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

Assessment ⬆ ⬇

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆