There is no doubt that creatine is a very popular supplement to increase muscle mass and resistance. It is widely used and is available without a prescription. However, like any synthetic supplement, it can interact with medications and even other supplements.

Is that your case? To find out, let's review some substances that interact with creatine and what can happen if we combine them.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Creatine can have a damaging effect on the kidneys if you don't drink enough fluids. That is why you should increase your consumption when you are consuming creatine. NSAIDs are commonly used to reduce inflammation, treat pain, and lower fever, but they can also interfere with kidney function (1).

When taken in high doses, NSAIDs can cause kidney damage, especially if you're taking creatine.

To prevent possible damage to the kidneys, it is advisable to stop taking creatine if you are going to start taking high doses of NSAIDs. Another option would be to adjust the dosage of the medication, but this should only be done with the help of your doctor.

Caffeine

Creatine works by helping your muscles produce more energy, but this process can be hampered by dehydration. Caffeine, a common stimulant drug, induces a diuretic effect and leads to increased urination. This can lead to dehydration, which makes it difficult for the body to use creatine properly. In addition, it could cause kidney damage if dehydration is significant or the creatine dose is very high.

There are also some studies that seem to point to a decreased absorption of creatine in the presence of caffeine (2). The studies are still inconclusive, but it is always important to be aware of potential risks.

ephedra

The combination of ephedra and creatine can have a profoundly detrimental effect on the human body. Both substances have the potential to interact with each other increasing the risk of stroke (3).

The potential interaction between ephedra and creatine can cause an increase in the body's blood pressure, which can lead to an increased risk of stroke. Additionally, this interaction can lead to overstimulation of the body's nervous system, which can lead to other health problems such as headaches, insomnia, blurred vision, and nausea.

diuretics

The combination of diuretics with creatine is not a good idea for reasons similar to those exposed when talking about caffeine. Diuretics are drugs that increase urination, which reduces the amount of water and electrolytes in the body.

The risk of dehydration and kidney damage is increased when diuretics are taken in combination with creatine. Creatine draws water into the muscles, and when combined with diuretics, water and electrolyte loss is increased. Additionally, dehydration caused by diuretics can increase the risk of heat stroke, a condition caused by prolonged exposure to heat, usually during athletic events.

probenecid

Probenecid is an oral drug used to treat and prevent gout, a type of arthritis caused by the buildup of uric acid crystals in the joints. It works by preventing the kidneys from reabsorbing uric acid, allowing it to be removed from the body.

But by interfering with kidney function, probenecid can also cause kidney stones and kidney damage (4). This risk is further increased in someone who is also taking creatine, especially if fluid intake is insufficient.

References:

1. Ejaz, P., Bhojani, K., & Joshi, VR (2004). NSAIDs and kidney. Japi , 52 (632-640), 371.
2. Vandenberghe, K., Gillis, N., Van Leemputte, M., Van Hecke, P., Vanstapel, F., & Hespel, P. (1996). Caffeine counteracts the ergogenic action of muscle creatine loading. Journal of applied physiology , 80 (2), 452-457.
3. Bailes, JE, Cantu, RC, & Day, AL (2002). The neurosurgeon in sport: awareness of the risks of heat stroke and dietary supplements. Neurosurgery , 51 (2), 283-288.
4. Pui, K., Gow, PJ, & Dalbeth, N. (2013). Efficacy and tolerability of probenecid as urate-lowering therapy in gout; Clinical experience in high-prevalence population. The Journal of rheumatology , 40 (6), 872-876.