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.

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

Contraindicated in:

• Allergy to creatine
• OB: Pregnancy and lactation.

Use Cautiously in:

• Renal dysfunction
• Liver disease
• Diabetes.

CV: arrhythmia, lower extremity deep vein thrombosis.

Derm: rash.

F and E: dehydration.

GI: abdominal pain, nausea, diarrhea.

GU: Increased serum creatinine , nephrotoxicity, altered liver function.

MS: muscle cramps.

Resp: shortness of breath.

Misc: weight gain, compartment syndrome.

Natural-Drug Products:

• May ↑ risk of nephrotoxicity with nephrotoxic drugs including aminoglycosides NSAIDs and cyclosporine.
• ↑risk of dehydration when used with diuretics.
• May interfere with effects of antidiabetic agents.

Natural-Natural Products:

• May ↑ risk of ischemic stroke when taken with caffeine and ephedra.

• Powder: ^OTC;
• Capsules: ^OTC;
• Liquid: ^OTC;

• 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.

phosphocreatine, tricreatine HCA, creatine phosphate

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

• Enhanced exercise performance.

Therapeutic Classification:

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Metabolized to creatinine and excreted renally.

Half-life: Unknown.

• Advise patient to maintain good hydration (at least 64 ounces of water/day) during creatine use.

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