Trokendi XR (topiramate) extended-release capsules

Overview of anticonvulsants

Anticonvulsants, or antiepileptic drugs, are a type of medication that treat several conditions, including epilepsy, seizure disorders, and for the prevention of migraines.

What is Trokendi XR?

Trokendi XR is a medication used for the prevention of migraine headache in adults and adolescents 12 years of age and older. People who experience frequent attacks of migraines may be prescribed a preventive medication like Trokendi XR. Trokendi XR is an extended-release formulation, which slowly releases topiramate (the same medication in Topamax® (topiramate)) over a 24-hour period.

What are the ingredients in Trokendi XR?

The active ingredient in Trokendi XR is topiramate extended-release.

How does Trokendi XR work?

The precise way Trokendi XR works is unknown. Doctors believe that its ability to block certain receptors in nerve cells and the brain to reduce electrical activity, or its ability to enhance the activity of the neurotransmitter (chemical messenger) gamma-aminobutyrate, may be how Trokendi XR can help prevent migraines.

What are the possible side effects of Trokendi XR?

Like all medications, Trokendi XR may cause unwanted side effects. The most common side effects experienced by patients taking Trokendi XR include tingling of the arms and legs (paresthesia), loss of appetite, weight loss, speech problems, fatigue, dizziness, drowsiness, nervousness, slowness of movement, abnormal vision, difficulty with memory, changes in the way food tastes, upper respiratory tract infections, abdominal pain, diarrhea, nausea, numbness, difficulty with concentration or attention, and fever.

Rarely, Trokendi XR may cause serious side effects, including eye problems, decreased sweating with fever, increased levels of acid in the blood, high levels of ammonia in the blood, kidney stones, or low body temperature that can lead to confusion or coma. Like other antiepileptic drugs, Trokendi XR may cause suicidal thoughts in a small number of people. Anyone who is taking Trokendi XR who experiences thoughts of suicide or other side effects that are alarming or do not go away should seek immediate medical attention.

Things to know about Trokendi XR

Trokendi XR can cause eye problems, including a decrease in vision and an increased pressure in the eye called secondary angle closure glaucoma. Patients experiencing any changes in their vision should see their doctor promptly.

Decreased sweating and elevated temperature (fever) have been reported with Trokendi XR, and this side effect has been especially seen in pediatric patients and may require hospitalization.
Women who are pregnant should not take Trokendi XR, as it can increase the risk of birth defects, particularly cleft lip, cleft palate, and small birth weight.

It is not known whether Trokendi XR passes into breast milk. Women who are breastfeeding should discuss the risks and benefits with their doctor.

Trokendi XR may affect motor abilities, vision, and thinking (cognition), which can impair driving or operating heavy machinery. People starting on Trokendi XR should refrain from driving or operating heavy machinery until they know how Trokendi XR affects them.


As an extended-release medication, one dose of Trokendi XR lasts for 24 hours. Trokendi XR comes in four strengths: 25 mg, 50 mg, 100 mg, and 200 mg. For the prevention of migraines, the initial dose is 25 mg once daily at bedtime for the first week. Swallow the capsule whole and intact. The dosage can be increased in the subsequent weeks by 25 mg to achieve the intended benefit (prevention of migraines). The recommended dose is 100 mg once daily. Do not consume alcohol 6 hours before or 6 hours after use of Trokendi XR. Do not stop taking the medication without consulting with your health care professional.1

For additional information on Trokendi XR, read the full prescribing information at

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