Creatine is a popular supplement used to increase muscle size and strength. The supplement is mostly safe to take with other medications or supplements. However, there are a few supplements and medications you should avoid taking at the same time as creatine.
Ephedra (ma huang) is a Chinese plant used to treat colds, headaches, congestion, and many other conditions. The plant is a stimulant and was previously an ingredient in some weight-loss and energy supplements. In 2004, the U.S. Food and Drug Administration (FDA) banned sales of supplements containing ephedra compounds due to their harmful side effects.
Stimulants like ephedra raise your heart rate and blood pressure. Combining this with creatine, other supplements, and exercise (which also raises your heart rate and blood pressure) can raise your risk for stroke.
One case study reported an athlete taking creatine, ephedra, caffeine, and other supplements experiencing a stroke. The mixture of supplements and physical activity likely caused the stroke. Based on this risk, it is best to avoid taking any type of ephedra product.
Caffeine is a popular stimulant that provides you with energy. Caffeine is a common ingredient in pre-workout supplements, providing an energy boost for exercise. However, taking creatine with caffeine may raise your risk for side effects and may affect how well creatine works.
Creatine needs water to work well in the body, while caffeine is a diuretic that gets rid of fluids in your body. If you are are not well hydrated or your creatine dose is very high, taking both creatine and caffeine can raise your risk for dehydration and raise your risk for kidney damage.
There are also reports that caffeine may affect how well creatine works, possibly by blocking creatine from being used as energy in the muscle cell. Overall, more studies are needed to understand how caffeine affects creatine.
In general, it is okay to take caffeine and creatine together. However, it is important that you are well hydrated if doing so. Up to 400 milligrams of caffeine and 3-5 grams of creatine a day is generally safe.
Diuretics are medications that help get rid of fluid in your body. They are used to treat a variety of conditions, including heart failure, high blood pressure, and hormonal acne. Examples of diuretics include Lasix (furosemide), Aldactone (spironolactone), and hydrochlorothiazide.
Similar to caffeine, diuretics lead to fluid loss and more urination, which can lead to dehydration. If taking creatine with a diuretic, you may raise your risk for dehydration and kidney disease.
Probenecid is a medication used to treat gout, a type of inflammatory arthritis caused by an excess of uric acid in the blood. The drug works by removing uric acid from your body, specifically making sure the kidneys do not reabsorb the product.
Probenecid can raise your risk for kidney stones and kidney damage. This is because the drug is removing uric acid through your urine (pee).
If you are not well hydrated and taking creatine with probenecid, you can raise your risk of kidney stones and kidney injury. Talk with a healthcare provider if you are taking probenecid and want to start using creatine.
For most people, taking creatine and protein powder is safe and may have performance benefits. However, there is a limit to how well both supplements actually help your muscles. Once your muscles have enough creatine and protein, your body will get rid of any excess.
Taking more than the recommended dosages of creatine or protein could raise your risk for stomach upset, dehydration, and kidney injury.
In general, creatine is a safe supplement. Overall, there are not many interactions with medications and supplements. The most common side effect of creatine is water retention, which may cause temporary weight gain. High doses of creatine may also cause stomach upset, diarrhea, nausea, and stomach pain.
