Trokendi XR is a prescription drug used in adults and some children to:
- help prevent migraine episodes
- treat epilepsy in people who also have one of the following:
- focal onset seizures (also known as partial seizures)
- generalized tonic-clonic seizures
- seizures related to Lennox-Gastaut syndrome (a rare form of severe epilepsy that often begins in childhood)
To learn more about the drug’s uses, see the “What is Trokendi XR used for?” section below.
Trokendi XR basics
Trokendi XR comes as a capsule that you take by mouth. It belongs to a group of drugs called anticonvulsants.
The active ingredient in Trokendi XR is extended-release (long-acting) topiramate. It’s not available in a generic form.
Read on to learn more about Trokendi XR’s side effects, dosages, and more.
Like most drugs, Trokendi XR may cause mild or serious side effects. The lists below describe some of its more common side effects. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
For more information on Trokendi XR’s side effects, see this article. Your doctor or pharmacist can also tell you about the potential side effects of Trokendi XR and suggest ways to help ease your symptoms.
Mild side effects
Here’s a list of some of the mild side effects that Trokendi XR can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Trokendi XR’s prescribing information.
Mild side effects of Trokendi XR that have been reported include:
- loss of appetite
- fatigue (low energy)
- problems with digestion, such as diarrhea, nausea, or belly pain
- tingling or numbness in your arms, hands, legs, or feet
- upper respiratory infections, such as the common cold
- impaired taste (changes in how things taste)
- problems with speech, such as trouble thinking of the right words to say
- slowed physical or mental activity, which can lead to memory or speech problems
- hair loss
- weight loss*
- mild eye side effects, such as blurry vision*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Trokendi XR can occur, but they aren’t common. If you have serious side effects from Trokendi XR, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Trokendi XR that have been reported include:
- high level of acid in the blood
- decreased sweating, which can lead to hyperthermia (very high body temperature)
- kidney stones
- high level of ammonia in the blood, which can lead to brain swelling
- severe rash and other serious skin reactions, such as toxic epidermal necrolysis
- severe changes in mood or memory
- severe eye side effects, such as vision loss*
- allergic reaction*
- depression, which may lead to suicidal thoughts or behaviors
* For more information about this side effect, see the “Side effect focus” section below.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Side effect focus
Learn more about some of the side effects Trokendi XR may cause.
Keep in mind that Trokendi XR may cause loss of appetite and problems with digestion, such as diarrhea, nausea, or belly pain. These side effects could cause you to eat less, which may lead to some weight loss.
What might help
If you’re concerned about weight loss with Trokendi XR, talk with your doctor. They can suggest ways to manage your weight while you’re taking the drug.
Some people may experience sleepiness with Trokendi XR. This was a common side effect reported in studies of the drug.
Along with sleepiness, you may also have fatigue (low energy). In studies of Trokendi XR, these side effects were more common with higher doses of the drug.
What might help
Sleepiness after taking Trokendi XR may lead to problems with thinking or coordination. These effects could be dangerous if they happen while you’re driving. For this reason, you may need to avoid driving until you know how Trokendi XR will affect you.
If Trokendi XR makes you sleepy, you may be able to take your dose at bedtime. But be sure to follow the instructions your doctor gives you for taking the drug.
If you’re concerned about sleepiness with Trokendi XR, talk with your doctor.
Eye side effects
Symptoms of pink eye can include:
- red or pink color in the whites of your eyes
- watery eyes
- eye burning, itching, or irritation
Although rare, Trokendi XR can also cause vision loss or secondary closed-angle glaucoma. With secondary closed-angle glaucoma, you have increased eye pressure caused by a blockage of fluid in the eye. This can cause sudden, severe eye pain and blurry vision. This condition can lead to blindness if it’s not treated.
What might help
If you have vision or eye problems while taking Trokendi XR, tell your doctor right away. They may check for symptoms of more severe eye problems.
If you have severe eye problems, your doctor may have you stop taking Trokendi XR. But if your eye side effects are mild, they may suggest treatments that could ease your symptoms.
Symptoms of a mild allergic reaction can include:
- skin rash
- flushing (temporary warmth, redness, or deepening of skin color)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Trokendi XR. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Trokendi XR that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Forms and strengths
Trokendi XR comes as a capsule that you take by mouth.
It’s available in four strengths: 25 milligrams (mg), 50 mg, 100 mg, and 200 mg.
Your doctor will usually start you on a low dose of Trokendi XR. They’ll adjust it over time until you reach the dose that treats your condition without causing bothersome side effects.
Your Trokendi XR dosage will be based on several factors, including:
- your age
- the condition you’re taking the drug to treat
- how well your condition is improving with the drug
- other medical conditions you have, such as kidney problems
- other medications you’re taking
- body weight (for children taking the drug)
To learn about Trokendi XR’s exact dosage for migraine prevention or epilepsy treatment, talk with your doctor. You can also see more dosage details in this article.
Questions about Trokendi XR’s dosage
Below are answers to a few questions about Trokendi XR’s dosages.
- What if I miss a dose of Trokendi XR? If you miss a dose of Trokendi XR, talk with your doctor. They can advise you on whether you should take the missed dose or skip it.
- Will I need to use Trokendi XR long term? Probably. If Trokendi XR is working well for you without causing bothersome side effects, you’ll likely take the drug long term.
- How long does Trokendi XR take to work? Trokendi XR starts working in your body as soon as you take it. But it may take several weeks for the symptoms of your condition to ease. If you have questions about what to expect with Trokendi XR treatment, talk with your doctor.
Before taking Trokendi XR, it’s important to talk with your doctor. Tell them about your overall health. Also discuss with them other medications you take and other medical conditions you have.
These factors and others are described in more detail below.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Trokendi XR, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Trokendi XR.
Interactions with drugs or supplements
Trokendi XR can interact with several types of drugs. These drugs include:
- certain other seizure drugs, such as:
- phenytoin (Dilantin, Phenytek)
- carbamazepine (Carbatrol, Tegretol)
- valproic acid*
- zonisamide (Zonegran)
- central nervous system depressants (medications that reduce the activity of your spinal cord and brain), including:
- benzodiazepines, such as alprazolam (Xanax)
- birth control pills
- the heart condition drugs hydrochlorothiazide and acetazolamide
- the diabetes drug pioglitazone (Actos)
- the mental health condition drugs lithium (Lithobid) and amitriptyline
This list does not contain all types of drugs that may interact with Trokendi XR. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Trokendi XR.
* Taking Trokendi XR with valproic acid may lead to hypothermia (very low body temperature). Your doctor can advise if it’s safe for you to take these medications together.
Before starting Trokendi XR treatment, tell your doctor if you follow a ketogenic diet.
You should talk with your doctor about the risks and benefits of taking Trokendi XR while following a ketogenic diet. If needed, your doctor can suggest a different diet to help manage your epilepsy.
Trokendi XR may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Trokendi XR. Factors to consider include those in the list below.
- Lung or breathing problems. Before taking Trokendi XR, tell your doctor about any lung or breathing problems you have. These conditions can raise your risk of having a high level of acid in your blood during your Trokendi XR treatment. Your doctor can tell you whether Trokendi XR is safe to take with your condition.
- Bone problems. Trokendi XR may cause a high level of acid in the blood as a side effect. This could increase your risk of osteoporosis. If you already have bone problems, talk with your doctor about whether Trokendi XR is safe for you to take.
- Kidney problems. Before taking Trokendi XR, tell your doctor if you have kidney problems, in particular, if you have kidney stones or receive dialysis. Having kidney problems could raise your risk of having kidney stones or a high level of acid with Trokendi XR. Your doctor may watch your acid levels more closely while you’re taking this drug. They may also give you a lower dose of Trokendi XR than what’s usually prescribed.
- Liver problems. Before taking Trokendi XR, tell your doctor about any liver problems you have. Liver problems can raise your risk of having a high level of ammonia in the blood during your Trokendi XR treatment. If you have liver problems, your doctor can determine if Trokendi XR is right for you.
- Mood changes or suicidal thoughts. In rare cases, Trokendi XR may cause depression, suicidal thoughts or behaviors, or other serious mood changes. Before taking Trokendi XR, tell your doctor if you have any of these conditions. They’ll determine if it’s safe for you to take this drug.
- Glaucoma. Before starting Trokendi XR treatment, tell your doctor if you have eye problems, such as glaucoma. The drug may cause a glaucoma attack (sudden eye pain and blurry vision) in people who have this condition. Your doctor can advise you on whether Trokendi XR is safe to take with your condition.
- Allergic reaction. If you’ve had an allergic reaction to Trokendi XR or any of its ingredients, your doctor will likely not prescribe Trokendi XR. Ask your doctor what other medications are better options for you.
- High level of acid in the blood. Trokendi XR may cause a high level of acid in your blood. If you’ve had this condition in the past, you may have a higher risk of getting it again. Your doctor will determine if it’s safe for you to take Trokendi XR. And they may monitor your acid levels more closely while you’re taking the drug.
- Following a ketogenic diet. Before you start taking Trokendi XR, tell your doctor if you follow a ketogenic diet. This type of diet could increase your risk of kidney stones or having a high level of acid in the blood as side effects. Talk with your doctor about the risks and benefits of taking Trokendi XR while following this diet.
Trokendi XR and alcohol
You should not drink alcohol within 6 hours before or after you’ve taken Trokendi XR. Doing so can worsen certain side effects of Trokendi XR, such as sleepiness and dizziness.
If you have questions about drinking alcohol during your Trokendi XR treatment, talk with your doctor or pharmacist.
Pregnancy and breastfeeding
Below is information about taking Trokendi XR while pregnant or breastfeeding.
Trokendi XR and pregnancy
It’s not safe to take Trokendi XR during pregnancy. Trokendi XR may cause side effects in children born to people who took the drug while pregnant. This includes children being smaller than usual for their age or having cleft palate and cleft lip.
If you’re pregnant or planning a pregnancy, talk with your doctor before taking Trokendi XR. They may recommend a different drug for your condition.
If you happen to take Trokendi XR during pregnancy, consider enrolling in the North American Antiepileptic Drug Pregnancy Registry. Pregnancy registries collect information about the safety of a drug when used during pregnancy.
To learn more, visit the registry’s website, call 888-233-2334, or talk with your doctor.
Trokendi XR and breastfeeding
It’s unknown whether Trokendi XR is safe to take while breastfeeding. This is because the drug passes into breast milk, which could cause a breastfed child to have diarrhea or sleepiness.
If you have questions about taking Trokendi XR while breastfeeding, talk with your doctor.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. And you can visit the Trokendi XR manufacturer’s website to see if they have support options.
You can also check out this article to learn more about saving money on prescriptions.
Keep reading to learn more about these conditions and how Trokendi XR is used to treat them.
Trokendi XR is used for migraine prevention in adults and in children ages 12 years and older.
Migraine is a condition that causes severe headache along with other symptoms. Examples include:
Trokendi XR is used for seizures that occur with epilepsy. It’s used for this purpose in adults and in children ages 6 years and older.
Trokendi XR is used to treat the following types of seizures:
- Focal seizures. Focal onset seizures (also known as partial seizures) may cause muscle stiffness or jerking, along with other symptoms. Examples include repeating phrases or words, daydreaming, or picking at clothing. For treating focal onset seizures, Trokendi XR may be used alone or with other epilepsy drugs.
- Generalized tonic-clonic seizures. Generalized tonic-clonic seizures also cause muscle stiffness or jerking, along with other symptoms. Examples include loss of consciousness, falling, or loss of bladder control. For treating generalized tonic-clonic seizures, Trokendi XR may be used alone or with other epilepsy drugs.
- Seizures related to Lennox-Gastaut syndrome (LGS). LGS may cause different types of seizures. The condition is a rare form of severe epilepsy that often begins in childhood. People with LGS may also have problems with learning, memory, thinking, attention, and development. For treating LGS, Trokendi XR is used with other epilepsy drugs.
Find answers to some commonly asked questions about Trokendi XR.
Is Trokendi XR a narcotic?
No, Trokendi XR isn’t a narcotic.
“Narcotic” usually refers to opioid drugs. This includes prescription opioids, such as oxycodone (OxyContin, Xtampza ER) and hydrocodone (Hysingla ER). But “narcotic” can also refer to illegal opioids, such as heroin.
Trokendi XR isn’t an opioid. Instead, it belongs to a group of drugs called anticonvulsants.
Is Trokendi XR classified as a controlled substance?
No, Trokendi XR is not classified as a controlled substance.
Controlled substances are drugs with a high risk of misuse or dependence. (Misuse refers to taking a drug in a way other than how a doctor prescribes it. Dependence happens when your body needs a drug to feel comfortable.) Controlled substances are closely regulated by the government because of these risks.
But Trokendi XR isn’t known to cause misuse or dependence, so it’s not a controlled substance.
How does Trokendi XR work? What’s its half-life?
Both migraine and seizures that occur with epilepsy may be caused by electrical activity in the brain. It isn’t known exactly how Trokendi XR works to treat these conditions. But it’s thought that the drug affects electrical activity in the brain, which may reduce the number of migraine episodes or seizures you have.
The half-life of Trokendi XR is about 31 hours. This means it takes about 31 hours for your body to get rid of half of a dose of Trokendi XR.
If you have other questions about how Trokendi works or how long it stays in your body, talk with your doctor or pharmacist.
Can Trokendi XR cause weight gain?
Trokendi XR isn’t likely to cause weight gain. In fact, weight loss is a common side effect of the drug. For more information about Trokendi XR and weight loss, see “Side effect focus” under “What are Trokendi XR’s side effects?” above.
If you’re concerned about weight changes while taking Trokendi XR, talk with your doctor. They can suggest ways for you to maintain a healthy weight.
Will I have withdrawal symptoms if I stop taking Trokendi XR?
No, you shouldn’t have withdrawal symptoms when stopping your Trokendi XR treatment. (Withdrawal symptoms are side effects that can happen after you stop taking a drug.) Withdrawal symptoms weren’t reported in studies of Trokendi XR.
But after you stop taking Trokendi XR, the symptoms of the condition you were taking it for may come back. This means you may have migraine episodes or seizures more often, or they may be more severe than usual. And if you’re taking Trokendi XR for epilepsy, suddenly stopping the drug could cause seizures.
For these reasons, you should not stop taking Trokendi XR unless your doctor tells you it’s safe to do so. If they tell you it’s safe, your doctor will likely lower your dose slowly over time. This reduces your risk of continued or worsening seizures after you stop taking Trokendi XR.
Does Trokendi XR cause you to feel ‘high’?
No, Trokendi XR likely won’t cause you to feel “high” (euphoric). This side effect wasn’t reported in studies of the drug.
If you’re concerned about how Trokendi XR will affect you, talk with your doctor.
You may wonder how Trokendi XR compares with similar drugs, such as Qudexy XR and Topamax.
Trokendi XR, Qudexy XR, and Topamax all contain the active drug topiramate. Trokendi XR and Qudexy XR contain extended-release (ER) topiramate, which is a long-acting form of the drug. Topamax contains immediate-release (IR) topiramate, which is a short-acting form of the drug.
Your doctor or pharmacist can tell you about the similarities and differences between the topiramate ER found in Trokendi XR and Qudexy XR.
To learn more about how Trokendi XR compares with the alternative drug Topamax, see this article. And you can talk with your doctor about which medication may be right for your condition.
Your doctor will explain how you should take Trokendi XR. They will also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Taking Trokendi XR
Trokendi XR comes as a capsule that you take by mouth.
Accessible medication containers and labels
If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text into audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.
Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Trokendi XR in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.
Taking Trokendi XR with other drugs
Examples of other epilepsy drugs include:
Your doctor will recommend the combination of drugs that’s best for you.
Questions about taking Trokendi XR
Below are answers to a few questions about taking Trokendi XR capsules.
- Can Trokendi XR be chewed, crushed, or split? No, you should not chew, crush, or split Trokendi XR capsules. You’ll swallow the capsules whole. If you have trouble swallowing Trokendi XR capsules, talk with your doctor or pharmacist.
- Should I take Trokendi XR with food? You can take Trokendi XR with food or without it.
Questions for your doctor
You may have questions about Trokendi XR and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Trokendi XR affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.
Do not take more Trokendi XR than your doctor prescribes. Using more than this can lead to serious side effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- belly pain
- vision changes, such as blurry vision or double vision
- loss of coordination
- convulsions, which may cause rigid muscles, uncontrolled muscle movements, or loss of consciousness
- memory problems
- low blood pressure
In rare cases, overdose of Trokendi XR has led to death.
What to do in case you take too much Trokendi XR
Call your doctor if you think you’ve taken too much Trokendi XR. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. However, if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Below are a few articles that contain helpful information about other medications for these conditions:
Also, here’s a list of questions you may want to ask your doctor about Trokendi XR:
- What other migraine or epilepsy treatments should I take with Trokendi XR?
- Should I follow a certain diet while taking Trokendi XR for epilepsy?
- Am I taking any medications that interact with Trokendi XR?
Can I switch to Trokendi XR from another form of topiramate?Anonymous
Possibly. If you were using another form of topiramate to prevent migraine or treat epilepsy, you may be able to switch to Trokendi XR. But before making any changes to your medications, talk with your doctor to see if this drug is right for you.
Trokendi XR is an extended-release (long-acting) form of topiramate that you take once per day. If you do switch to Trokendi XR, your doctor will determine the right dosage based on your previous dosage of topiramate.Victor Nguyen, PharmD, MBAAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.