Trokendi XR™ (topiramate)

Trokendi XR™ (topiramate) is indicated for the prophylaxis of migraine in patients 12 years of age and older. It is taken by mouth as prophylactic therapy to reduce migraine frequency. For those with frequent migraine attacks or migraine that do not respond to acute treatment, preventive medications can be important.

Trokendi XR is an extended-release formulation of topiramate, the same medication in Topamax®.

What are the ingredients in Trokendi XR?

The active ingredient in Trokendi XR is topiramate.

How does Trokendi XR work?

The precise way Trokendi XR works to prevent migraine is unknown. It is thought that the medication blocks sodium channels and increases the activity of neurotransmitters in the brain. This likely inhibits some of the receptors in nerve cells, which reduce electrical activity and contribute to the development of migraine.

What are the possible side effects of Trokendi XR?

Many clinical trials evaluated the safety and efficacy of Trokendi XR. The most common side effects experienced by those taking Trokendi XR include:

  • Hypoesthesia
  • Taste disturbances
  • Numbness or tingling in the fingers and toes (paresthesia)
  • Anorexia
  • Weight loss
  • Diarrhea
  • Abdominal pain
  • Nausea
  • Upper respiratory infections
  • Speech and memory difficulties

This is not an exhaustive list of all potential side effects of Trokendi XR. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Trokendi XR, contact your doctor or healthcare provider immediately.

Things to note about Trokendi XR

Trokendi XR capsules are taken by mouth with water or other liquids. Trokendi XR is taken once a day for effectiveness in reducing the frequency of migraine. The extended release capsules supply a steady stream of medication over 24 hours. The medication is generally most effective after 1 month of use. Before starting Trokendi XR talk with your doctor if you:

  • Have a history of hypersensitivity to topiramate
  • Have used alcohol within 6 hours prior to use or plan to use alcohol within 6 hours after dosing
  • Have acute myopia and secondary angle closure glaucoma
  • Have visual field defects
  • Have a history of oligohydrosis (decreased sweating) and hyperthermia (fever)
  • Have a history metabolic acidosis
  • Have taken antiepileptic drugs
  • Have taken other carbonic anhydrase inhibitors
  • Have taken valproic acid
  • Have taken anti-depressants
  • Have a history of depression or suicidal ideation
  • Have a history of kidney stones
  • Have a history of weak, brittle or soft bones
  • Have lung or breathing problems
  • Are planning on having surgery
  • Are on a high fat diet/low carbohydrate diet
  • Are pregnant or planning to get pregnant. Topiramate can cause fetal harm when administered to a pregnant woman.

Individuals with the above conditions should be monitored closely while taking Trokendi XR.

Dosing Information

The initial dose of Trokendi XR titration, and recommended maintenance dose, varies by indication and age group. Extended-release capsules come in 4 strengths: 25 mg, 50 mg, 100 mg, and 200 mg.

The recommended total daily dose of Trokendi XR as treatment for prevention of migraine in patients 12 years of age and older is 100 mg once daily. Trokendi XR is generally titrated according to the following schedule:

  • Week 1: 25 mg once daily
  • Week 2: 50 mg once daily
  • Week 3: 75 mg once daily
  • Week 4: 100 mg once daily

A physician will guide the dose and titration rate, based on individual medical circumstances, and clinical outcomes. Longer intervals between dose adjustments can be used.

Trokendi XR capsules can be taken with or without food. Capsules should be swallowed whole. Do not open and sprinkle on food, chew, or crush the medication.

Do not suddenly stop taking Trokendi XR without talking to your doctor, as serious complications can arise.

Keep track of when you have migraine attacks and when you take Trokendi XR so you can monitor its effectiveness, and communicate with your doctor about how the medication is working for you.

Before taking Trokendi XR make sure to tell your doctor about all the medicines you take, including prescription and nonprescription, vitamins, and herbal supplements. Trokendi XR and other medicines may impact each other, causing side effects.

Because Trokendi XR can cause dizziness, weakness, and drowsiness, do not drive a car, use machinery, or do anything requiring you to be fully alert when taking this medication.

For additional details, read the full prescribing information of Trokendi XR.

Written by: Linda Saxl Minton | Last reviewed: June 2018.
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