Creatine and Medicines: NSAIDs, Diuretics and Other Drugs That Affect the Kidneys
What a 2026 evidence review found about creatine and medicines such as NSAIDs and water tablets, why no human interaction studies exist, and why a pharmacist should be asked.
Content last updated . This page has not been medically reviewed.
This page is information only. A pharmacist or clinician who knows your medicine list can say what applies to you, and nothing here is a reason to stop or change a prescribed medicine.
How the evidence is labeled
Insufficient evidence means too few or no human studies to say. Preclinical or theoretical means the concern comes from how the body handles a substance, not from patients. Proper evidence not found means we looked and found nothing usable.Why kidney-affecting medicines come up
Creatinine is a waste product made when muscle tissue breaks down, and it is measured to check the kidneys. [2] Creatine supplements raise blood creatinine. A 2026 meta-analysis of 26 trials (1036 participants) found a rise of 0.14 mg/dL, and its authors concluded this likely reflects altered creatinine handling rather than kidney injury, because a direct filtration measure did not change. [3] The test page also says certain medicines and supplements can affect creatinine results, so a clinician reading them needs to know everything you take. [2]NSAIDs
NSAIDs (non-steroidal anti-inflammatory drugs) include ibuprofen and aspirin, which are sold without a prescription. [4] The NHS lists kidney problems among their possible serious side effects, with signs such as shortness of breath, blood in the pee, or swelling in the ankles, feet or hands. [4] No study we read tested creatine with an NSAID. Proper evidence not found for creatine plus NSAIDs in people, searched in PubMed and in the 2026 review above.Diuretics (water tablets)
A diuretic makes you pee more, and furosemide is one example. [5] The review notes that creatine's effects on cell hydration and kidney handling can overlap with how diuretics work, but calls these mechanisms largely theoretical and not shown in controlled human studies. [1] The NHS warns that vomiting, diarrhoea or fever while taking furosemide raises the risk of dehydration. [5] People are often given diuretics because of heart, kidney or liver conditions. [5]Frequently asked questions
Does creatine interact with ibuprofen or other NSAIDs?
No human study we read tested this. Interaction databases list NSAID flags as minor and theoretical. [1] The NHS lists kidney problems among NSAIDs' possible serious side effects. [4] Ask a pharmacist.
Can I take creatine with water tablets?
Proper evidence not found from human studies. The 2026 review calls the overlap largely theoretical. [1] Because diuretics can cause dehydration, ask the clinician who prescribed yours. [5]
Why does creatine change my creatinine blood test?
Creatinine comes from muscle breakdown, and creatine supplements raise it without clear kidney injury on a direct measure. [2] [3]
Should I stop a medicine because I take creatine?
No. Do not stop any medicine unless your provider tells you to. [2]
Is it safe to say there are no interactions?
No. The review says the lack of evidence is not proof that interactions cannot occur. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
What the interaction databases flag
| Source checked | What it listed | Strength of evidence |
|---|---|---|
| Medscape checker (as reported) | 46 minor flags, mainly NSAIDs and salicylates and ACE inhibitors [1] | Theoretical, no confirmed outcomes |
| DDInter (as reported) | Two moderate (pemetrexed, entecavir) and three minor (cimetidine, trimethoprim, probenecid) [1] | Theoretical, no confirmed outcomes |
| Human trials of creatine plus a drug | None met the review's criteria [1] | Insufficient evidence |
The review's author discloses creatine-related advisory roles, intellectual property and industry funding. [1] The review itself concludes that current evidence does not support routinely avoiding creatine in people taking these medicines, but still calls for individual clinical judgment. [1]
Who should ask first
More: medication interactions, creatine, kidney questions and creatinine testing, creatine and kidney disease, caffeine and alcohol with creatine, quality testing and multiple medicines and supplements.
References
- Ostojic SM. Potential interactions between creatine supplementation and prescription drugs: a narrative review and evidence-mapping perspective. Curr Ther Res Clin Exp 2026 (full text read via PMC13584064; the author reports creatine-related advisory roles, intellectual property and industry funding). Read 2026-10-23.
- MedlinePlus. Creatinine Test. U.S. National Library of Medicine. Read 2026-10-23.
- de Souza Almeida A, da Silva LOD, Takahasi BNA, et al. Impact of creatine supplementation on kidney health: a systematic review and meta-analysis. Int Urol Nephrol 2026 (abstract read). Read 2026-10-23.
- NHS. Non-steroidal anti-inflammatory drugs (NSAIDs). Page last reviewed 28 April 2026. Read 2026-10-23.
- NHS. Furosemide. Page last reviewed 7 July 2026. Read 2026-10-23.
- Pereira JP, Leal VO, Trigueira P, et al. Creatine supplementation in patients with kidney disease - harm or benefit? Nephrol Dial Transplant 2026 (narrative review, abstract read). Read 2026-10-23.