creatine

What is the most important information I should know about creatine?

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is creatine?

Creatine is a manmade form of a chemical that is normally found in the body. Creatine is also found in meat and fish. Most creatine in the human body is stored in the muscles. Creatine is a source of energy for muscle contraction and is also involved in muscle growth.

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

Creatine has also been used to treat rheumatoid arthritis, or Lou Gehrig's disease (ALS). However, research has shown that creatine may not be effective in treating these conditions.

Other uses not proven with research have included treating high cholesterol, depression, bipolar disorder, or certain muscle diseases.

Creatine is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Creatine may also be used for purposes not listed in this product guide.

What should I discuss with my healthcare provider before taking creatine?

• 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 be as effective in improving strength or building muscle in people over 60 years old.

How should I take creatine?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use creatine, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label. High doses may cause harmful effects on your heart, kidneys, or liver.

Some athletes have used a "loading method" of taking creatine by using large doses for 2 to 5 days, followed by smaller "maintenance" doses. This method has been used by athletes seeking a short-term increase in athletic ability, such as before a sporting competition.

Another method of creatine use involves taking smaller doses over an extended training period. This method has been used by people seeking endurance for long-term training such as body-building.

Muscle tissues can only hold a certain amount of creatine. Using more of this product will not increase any effects.

Do not use different forms (tablets, liquid, powder, beverages, etc) of creatine at the same time without medical advice. Using different formulations together increases the risk of an overdose.

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

What happens if I miss a dose?

Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra creatine to make up the missed dose.

What happens if I overdose?

Creatine can cause kidney damage when used over a long period or if your daily doses are too high.

What should I avoid while taking creatine?

Avoid drinking caffeine (coffee, tea, soda) or taking herbal stimulants such as ephedra or Ma Huang while you are taking creatine. Combining creatine with these substances may increase your risk of having a stroke or other serious medical problems.

What are the possible side effects of creatine?

• 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 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.

What other drugs will affect creatine?

Creatine can harm your kidneys. This effect is increased when you also use certain other medicines, including:

• 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.

Where can I get more information?

Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.