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It does not directly interact with tirzepatide or semaglutide at the molecular level, meaning there is no known chemical reaction between creatine and GLP-1 receptor agonists

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Tashiro Y, Sato K, Watanabe T, Nohtomi K, Terasaki M, Nagashima M, Hirano T

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We propose that the poor efficacy of the analogues containing ( S,S )-ACPC arises because this residue stabilizes the helical conformation near the N-terminus, relative to the native Gly, and thereby raises the energy barrier between the partially engaged and fully engaged states