What Is Creatine and How Does It Work?

Phosphocreatine serves as phosphate donor to generate ATP from ADP. Creatine suggested uses for ALS (amyotrophic lateral sclerosis), chronic heart failure (CHF), exercise performance enhancement, gyrate atrophy (chorioretinal degeneration resulting in blindness (GA), McArdle disease, mitochondrial cytopathies (multisystem disorders which preferentially affect the muscle and nervous systems), muscle mass builder, muscular dystrophies, neuromuscular disease, rheumatoid arthritis, and Parkinson's disease.

  • Creatine is available under the following different brand names: amidinosarcosine, creatine citrate, creatine monohydrate, creatine phosphate, and N-amidinosarcosine.
  • Athletic performance: Creatine seems to enhance muscle performance during repeated bouts of brief, high-intensity exercise. Does not seem to improve performance in aerobic exercises, or provide benefit to older individuals or highly trained athletes.
  • Chronic heart failure: When creatine is taken orally, it improves exercise tolerance but does not affect the ejection fraction. IV creatinine improves cardiac function, including ejection fraction.
  • Gyrate atrophy: Creatine seems to slow visual deterioration.
  • McArdle's disease: Preliminary clinical evidence suggests that it can increase exercise capacity and decrease exercise-induced muscle pain.
  • Parkison's disease: Some evidence shows that it can decrease rate of disease progression in early stages.
  • Idiopathic inflammatory myopathies (disease of muscle tissue): more evidence is needed to determine effectiveness.
  • Possibly ineffective for amyotrophic lateral sclerosis (ALS), rheumatoid arthritis, and schizophrenia.

What Are Dosages of Creatine?

Dosages of Creatine Should Be Given As Follows: Exercise Performance Enhancement
  • Initial dose: 20 g by mouth each day for 5 days
  • Maintenance: 2-3 g by mouth each day
Chronic Heart Failure
  • 20 g by mouth daily for 5 to 10 days
Parkinson's Disease
  • 10 g by mouth each day
Gyrate Atrophy
  • 1.5 g by mouth daily

McArdle Disease

  • Initial: 150 mg/kg per day for 5 days, then 60 mg/kg per day by mouth
Muscular Dystrophies
  • 10 g by mouth daily
Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's Disease)
  • 10 g by mouth per day for 12-16 months
Idiopathic Inflammatory Myopathies
  • 20 g per day for 8 days, then 3 g per day for 6 months.
Dosage Considerations
  • There are no dosage considerations for the use of creatine.

What Are Side Effects Associated with Using Creatine?

Side effects of creatine include:

What Other Drugs Interact with Creatine?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

  • Creatine has mild interactions with at least 45 different drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Creatine?


  • This medication contains creatine. Do not take amidinosarcosine, creatine citrate, creatine monohydrate, creatine phosphate, and N-amidinosarcosine, if you are allergic to creatine or any ingredients contained in this drug.
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.


Effects of Drug Abuse

  • There are no effects of drug abuse associated with the use of creatine.

Short-Term Effects

  • There are no short-term effects associated with the use of creatine.

Long-Term Effects

  • There are no long-term effects associated with the use of creatine.


  • Use caution when using creatine concurrent with other nephrotoxic agents.

Pregnancy and Lactation

  • Avoid use when pregnant and/or lactating. Consult with your physician.
Medscape. Creatine.

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