Drug & supplement interaction

Creatine + Sarilumab

Sarilumab brand name: Kevzara.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Creatine and Sarilumab in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Creatine and Sarilumab

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Sarilumab and Creatine in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Creatine at all — not against Sarilumab, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Creatine safety at a glance

Creatine overall Use caution Generally well tolerated in healthy adults, but those with kidney issues should be careful.
Pregnancy Avoid Safety during pregnancy has not been established, so it is best avoided.
Breastfeeding Avoid There is not enough safety information for nursing mothers, so avoid use.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Sarilumab and Creatine? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Creatine and Sarilumab May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Liver problems Worth acting on Additional detail

    Creatine

    “Despite two case reports describing hepatic injury in patients taking creatine, meta-analyses and clinical studies specifically evaluating the safety of creatine have not identified an increased risk for hepatic injury. In addition, population research suggests that there is not an association between creatine intake and liver fibrosis, cirrhosis, or hepatic steatosis.”

    Creatine · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 46701. Whitt, K. N., Ward, S. C., Deniz, K., Liu, L., Odin, J. A., and Qin, L. Cholestatic liver injury associated with whey protein and creatine supplements. Semin.Liver Dis. 2008;28(2):226-231. PubMed
    2. 90319. Vilella AL, Limsuwat C, Williams DR, Seifert CF. Cholestatic jaundice as a result of combination designer supplement ingestion. Ann Pharmacother 2013;47(7-8):e33. PubMed
    3. 103278. de Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. Risk of adverse outcomes in females taking oral creatine monohydrate: a systematic review and meta-analysis. Nutrients. 2020;12(6):E1780. PubMed
    4. 103279. Almeida D, Colombini A, Machado M. Creatine supplementation improves performance, but is it safe? Double-blind placebo-controlled study. J Sports Med Phys Fitness. 2020;60(7):1034-9. PubMed
    5. 112208. Todorovic N, Korovljev D, Stajer V, Jorga J, Ostojic SM. Creatine consumption and liver disease manifestations in individuals aged 12?years and over. Food Sci Nutr 2022;11(2):1134-1141. PubMed
    6. 46521. Robinson, T. M., Sewell, D. A., Casey, A., Steenge, G., and Greenhaff, P. L. Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function. Br.J Sports Med 2000;34(4):284-288. PubMed

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab. Read the label on DailyMed ›

  • Muscle pain Additional detail

    Creatine

    “Orally, creatine is generally well-tolerated. Topically, a thorough evaluation of safety outcomes has not been conducted.

    Most Common Adverse Effects:

    Orally: Dehydration, diarrhea, gastrointestinal upset, muscle cramps, and water retention.

    Serious Adverse Effects (Rare):

    Orally: Case reports have raised concerns about interstitial nephritis, renal insufficiency, rhabdomyolysis, and venous thrombosis.”

    Creatine · Natural Medicines adverse-effect record, reported in diarrhea.

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab. Read the label on DailyMed ›

  • A skin rash / Itching reported in 13.3% of FDA reports for Sarilumab Additional detail

    Creatine

    “In a small clinical trial of older, healthy males, one subject out of the 10 receiving creatine 5 grams four times daily for 10 days followed by 4 grams daily for 20 days reported a skin rash during the study. The type and severity of rash and whether it resolved after creatine was discontinued were not discussed. Also, skin rash has been reported by patients taking celecoxib and creatine;”

    Creatine · Natural Medicines adverse-effect record, reported in pruritus.

    3 sources cited
    1. 4572. Rawson ES, Wehnert ML, Clarkson PM. Effects of 30 days of creatine ingestion in older men. Eur J Appl Physiol Occup Physiol 1999;80:139-44. PubMed
    2. 46706. Gordon, P. H., Cheung, Y. K., Levin, B., Andrews, H., Doorish, C., Macarthur, R. B., Montes, J., Bednarz, K., Florence, J., Rowin, J., Boylan, K., Mozaffar, T., Tandan, R., Mitsumoto, H., Kelvin, E. A., Chapin, J., Bedlack, R., Rivner, M., McCluskey, L.
    3. 104669. Whinton AK, Donahoe K, Gao R, et al. Repeated application of a novel creatine cream improves muscular peak and average power in male subjects. J Strength Cond Res. 2020;34(9):2482-2491. PubMed

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Constipation Additional detail

    Creatine

    “Some small clinical studies have reported diarrhea and vomiting with oral creatine supplementation. Also, gastrointestinal distress, transient abdominal discomfort, constipation, heartburn, and nausea have been reported by a small number of individuals in randomized, controlled clinical trials,.”

    Creatine · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 4584. Juhn MS, O'Kane JW, Vinci DM. Oral creatine supplementation in male collegiate athletes: a survey of dosing habits and side effects. J Am Diet Assoc 1999;99:593-5.
    2. 11332. Groeneveld GJ, Veldink JH, van der Tweel I, et al. A randomized sequential trial of creatine in amyotrophic lateral sclerosis. Ann Neurol 2003;53:437-45. . PubMed
    3. 46562. Chrusch, M. J., Chilibeck, P. D., Chad, K. E., Davison, K. S., and Burke, D. G. Creatine supplementation combined with resistance training in older men. Med Sci.Sports Exerc. 2001;33(12):2111-2117. PubMed
    4. 46684. Cramer, J. T., Stout, J. R., Culbertson, J. Y., and Egan, A. D. Effects of creatine supplementation and three days of resistance training on muscle strength, power output, and neuromuscular function. J Strength.Cond.Res 2007;21(3):668-677. PubMed
    5. 46698. Ostojic, S. M. and Ahmetovic, Z. Gastrointestinal distress after creatine supplementation in athletes: are side effects dose dependent? Res.Sports Med. 2008;16(1):15-22. PubMed
    6. 46704. Koenig CA, Benardot D Cody M Thompson WR. Comparison of creatine monohydrate and carbohydrate supplementation on repeated jump height performance. J Strength Cond Res. 2008;22(4):1081-1086. PubMed

    Sarilumab

    Listed in the ADVERSE REACTIONS section of the FDA label for Sarilumab. Read the label on DailyMed ›

Reported for Creatine but not commonly for Sarilumab: stomach upset, heart failure, an electrolyte imbalance and blood clots.

Effects for Sarilumab come from the ADVERSE REACTIONS section of its FDA label; effects for Creatine come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 24,738 voluntary FDA FAERS reports for Sarilumab that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Creatine or Sarilumab

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Creatine or Sarilumab, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sarilumab

This page covers Creatine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sarilumab page lists 72 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Active Hexose Correlated Compound (ahcc) (moderate), Alfalfa (moderate), Alkanna (moderate), Alpine Ragwort (moderate) and American Ginseng (moderate).

By severity: 71 moderate · 1 minor.

From our pharmacist’s overview on the Sarilumab page

“Sarilumab (Kevzara) works by quieting an overactive immune system in rheumatoid arthritis, and most of the supplements on this page push the other way. Immune stimulants such as ashwagandha, astragalus, and American ginseng could in theory blunt the drug's benefit and let joint symptoms creep back.”

Reviewed by 2 · Jul 18, 2026

Open the Sarilumab interaction page

One more smart check

Taking Creatine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,825 real supplement products containing Creatine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Creatine. Even though Creatine itself has no known interaction with Sarilumab, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Creatine and Sarilumab Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Creatine
Top 5%

#48 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sarilumab
Steady interest

#2,207 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Creatine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Creatine and Sarilumab records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Creatine

What is Creatine?

Creatine
  • Improving high-intensity exercise performance
  • Building muscle strength and size
  • Sports and athletic training
  • Recovery from workouts
  • Possible support for brain and cognitive function

Creatine is one of the most studied sports supplements, with solid evidence that it can boost strength and performance during short, high-intensity activities like weightlifting and sprinting. It is generally well tolerated in healthy adults, though it can cause water retention and minor stomach upset. People with kidney problems and those who are pregnant or breastfeeding should check with a doctor before using it.

Not applicable (a compound made in the body and found in meat and fish) · Powder, capsules, tablets, chewables, and drink mixes

An interaction check asks whether these two react with each other — it does not ask whether Creatine is a good idea for someone in your situation. Here is what our Creatine record says about it on its own.

Creatine: dosing

There is no single official dose for everyone, and the right amount can depend on your body size, diet, and goals. Many products suggest an optional short 'loading' period followed by a smaller daily 'maintenance' amount, but a steady daily approach also works for building muscle creatine over time.The best advice is to follow the directions on the product label and choose a reputable brand, ideally one tested by a third party. Creatine monohydrate is the most studied and usually the most affordable form.

From our Creatine monograph — the full record covers uses, side effects and every documented interaction.

Read the full Creatine monograph & all interactions
Medication

About Sarilumab Injection

What Is Sarilumab Injection Used For?

Brand name: Kevzara

Kevzara (sarilumab) injection is approved for three conditions. In adults, it treats moderately to severely active rheumatoid arthritis (RA) when at least one other disease-modifying drug hasn't worked well enough or caused intolerance. It also treats polymyalgia rheumatica (PMR) in adults who haven't responded adequately to corticosteroids or who can't tolerate tapering them.

Kevzara is also approved for polyarticular juvenile idiopathic arthritis (pJIA) — a form of childhood arthritis — but only in patients who weigh 63 kg (about 139 lbs) or more. It is not approved for pediatric patients below that weight due to the lack of an appropriate dosage form.

Most-Reported Side Effects for Sarilumab

From FAERS, the FDA’s public side-effect reporting system (26,260 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Arthralgia 5,168 reports
Rheumatoid arthritis 4,646 reports
Joint swelling 4,578 reports
Fatigue 3,555 reports
Rash 3,349 reports
See full Sarilumab Injection drug information
Keep checking

Other Drugs & Creatine

Browse every other medication we’ve checked against Creatine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
No interaction 2,829 drugs checked — show the list
Evidence & sources

Creatine References

The 86 references that drive our Creatine monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Koshy KM, Griswold E, Schneeberger EE. Interstitial nephritis in a patient taking creatine. N Engl J Med 1999;340:814-5. PubMed
  2. Vahedi K, Domingo V, Amarenco P, Bousser MG. Ischemic stroke in a sportsman who consumed MaHuang extract and creatine monohydrate for bodybuilding. J Neurol Neurosurg Psychiatr 2000;68:112-3.
  3. Greenhaff P. Renal dysfunction accompanying oral creatine supplements. Lancet 1998;352:233-4. PubMed
  4. Vandenberghe K, Goris M, Van Hecke P, et al. Long-term creatine intake is beneficial to muscle performance during resistance training (abstract). J Appl Physiol 1997;83:2055-63. PubMed
  5. Hultman E, Soderlund K, Timmons JA, et al. Muscle creatine loading in men. J Appl Physiol 1996;81:232-7. PubMed
  6. Pritchard NR, Kalra PA. Renal dysfunction accompanying oral creatine supplements. Lancet 1998;351:1252-3. PubMed
  7. Poortmans JR, Auquier H, Renaut V, et al. Effect of short-term creatine supplementation on renal responses in men (abstract). Eur J Appl Physiol Occup Physiol 1997;76:566-7. PubMed
  8. Poortmans JR, Francaux M. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc 1999;31:1108-10. PubMed
  9. Mihic S, MacDonald JR, McKenzie S, Tarnopolsky MA. Acute creatine loading increases fat-free mass, but does not affect blood pressure, plasma creatinine, or CK activity in men and women. Med Sci Sports Exerc 2000;32:291-6. PubMed
  10. Rawson ES, Wehnert ML, Clarkson PM. Effects of 30 days of creatine ingestion in older men. Eur J Appl Physiol Occup Physiol 1999;80:139-44. PubMed
  11. Earnest CP, Almada AL, Mitchell TL. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin Sci (Colch) 1996;91:113-8. PubMed
  12. Juhn MS. Oral creatine supplementation. Separating fact from hype. Phys Sportsmed 1999;27:47-50,53-54,56,61,89. PubMed
  13. Juhn MS, O'Kane JW, Vinci DM. Oral creatine supplementation in male collegiate athletes: a survey of dosing habits and side effects. J Am Diet Assoc 1999;99:593-5.
  14. Green AL, Hultman E, Macdonald IA, et al. Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. Am J Physiol 1996;271:E821-6. PubMed
  15. Balsom PD, Soderlund K, Sjodin B, Ekblom B. Skeletal muscle metabolism during short duration high-intensity exercise: influence of creatine supplementation. Acta Physiol Scand 1995;154:303-10. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Creatine and Sarilumab Together: Common Questions

Is it safe to take Creatine with Sarilumab?
We do not list a known interaction between Creatine and Sarilumab. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Creatine and Sarilumab have any of the same side effects?
Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Sarilumab interact with any supplements?
Yes. Sarilumab has documented interactions with 72 supplements in our database — Creatine is not one of them. The Sarilumab interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.