If you have migraine or certain types of epilepsy, your doctor might suggest Trokendi XR (topiramate) as a treatment option for you. Knowing Trokendi XR’s possible side effects can help you and your doctor decide whether to add it to your treatment plan.

Trokendi XR is a prescription medication used to:

  • prevent migraine headaches in adults and some children
  • treat epilepsy in adults and some children who experience:
    • seizures related to Lennox-Gastaut syndrome

Depending on the condition it’s treating, Trokendi XR may be used alone or with other drugs.

This drug comes as an extended-release capsule that you take by mouth. If you and your doctor agree that Trokendi XR is working well for your condition, you’ll likely take the medication long term.

For more information about Trokendi XR, including details about its uses, see this in-depth article.

Like other drugs, Trokendi XR can cause mild or serious side effects. Keep reading to learn more.

Below are just a few of the more common side effects reported by people who took Trokendi XR in studies. These side effects can vary depending on what condition the drug is being used to treat.

More common side effects in people taking Trokendi XR for epilepsy include:

More common side effects in people taking Trokendi XR for preventing migraine headaches include:

* To learn more about this side effect, see the “Side effects explained” section below.

Keep reading to learn about other possible mild and serious side effects of Trokendi XR.

Like most drugs, Trokendi XR can cause mild side effects. Some of these may be more common than others. But in general, many people who take Trokendi XR don’t experience side effects.

Examples of mild side effects that have been reported with Trokendi XR include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. Do not stop using Trokendi XR unless your doctor recommends it.

Trokendi XR may cause mild side effects other than the ones listed above. See the Trokendi XR prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Trokendi XR, visit MedWatch.

Treatment with Trokendi XR may cause serious side effects.

Serious side effects that have been reported with Trokendi XR include:

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Trokendi XR. But it’s not clear whether this side effect occurred in studies.

If you develop serious side effects while taking Trokendi XR, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

SUICIDE PREVENTION

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.

Learn more about some of the side effects Trokendi XR may cause.

Weight loss

You may have weight loss as a side effect of taking Trokendi XR. This was among the more common side effects reported in studies of the drug, regardless of the condition it was treating.

Trokendi XR can also cause decreased appetite as a side effect. This may make you feel less hungry and lead to weight loss.

What might help

Talk with your doctor if you’re concerned about your weight while taking Trokendi XR. They may suggest ways to treat this side effect. But if the weight loss is troubling or doesn’t resolve, your doctor may suggest a treatment other than Trokendi XR for your condition.

Hair loss

Although not common, hair loss is a side effect you may have from taking Trokendi XR.

In studies, this side effect was reported only in people taking Trokendi XR for epilepsy. No one taking the drug to prevent migraine headaches reported hair loss as a side effect.

What might help

If you have hair loss while taking Trokendi XR, talk with your doctor. They may suggest a treatment for this side effect or tips for preventing it. Or they may recommend you stop taking Trokendi XR and try a different medication for your condition.

Other drugs used to treat epilepsy, including valproic acid and carbamazepine (Tegretol, Carbatrol), can also cause hair loss. So when discussing hair loss with your doctor, be sure they’re aware of all medications you may be taking to treat epilepsy.

Vision problems

Trokendi XR can cause vision problems. While these were rare in studies of the drug, vision problems caused by Trokendi XR can be severe.

Vision problems reported by people taking Trokendi XR in these studies include:

  • secondary closed-angle glaucoma (increased eye pressure caused by a blockage of fluid in the eye)
  • sudden changes in vision

In addition to sudden changes in vision, symptoms of eye problems Trokendi XR may cause include:

These side effects are most likely to occur during your first month of taking Trokendi XR.

Left untreated, vision problems caused by Trokendi XR can cause permanent vision loss.

What might help

If you notice symptoms of vision problems while taking Trokendi XR, contact your doctor right away. They’ll likely recommend you stop taking the drug and suggest other treatments for your condition.

Decreased sweating

Taking Trokendi XR can cause decreased sweating as a side effect, though this is not common. Decreased sweating can cause an increase in your body temperature. In extreme cases, this rise in body temperature can require treatment in the hospital.

Most cases of decreased sweating caused by Trokendi XR have been in children taking the drug. Some cases were reported after people spent significant time outside in hot weather.

Symptoms can include:

  • chills
  • fever
  • not sweating in hot temperatures

What might help

While taking Trokendi XR, pay close attention for any of the symptoms listed just above. Also, try to avoid spending lots of time in hot weather or environments.

If you develop a severe fever or one that doesn’t go away, or you notice decreased sweating while taking Trokendi XR, contact your doctor right away. They’ll likely recommend you stop taking Trokendi XR and suggest other treatments for your condition.

Allergic reaction

Like most drugs, Trokendi XR can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage your symptoms, they may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Trokendi XR, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Trokendi XR, they may have you switch to a different treatment.

Keeping track of side effects

During your Trokendi XR treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful when you start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Trokendi XR affects you. And your doctor can use this information to adjust your treatment plan if needed.

Keep reading for answers to some frequently asked questions about Trokendi XR’s side effects.

Where can I find reviews of Trokendi XR that discuss side effects?

The manufacturer of Trokendi XR has a few video testimonials from people who have taken the drug. You can view these on its website.

Keep in mind that side effects from Trokendi XR vary for each individual. Some people may have side effects from taking the drug, and others may not.

To learn more, ask your doctor or pharmacist what others have experienced while taking Trokendi XR.

Does my risk of side effects from Trokendi XR increase depending on the dose I take (25 mg, 50 mg, 100 mg, 200 mg)?

Yes, your risk of side effects might increase with higher doses of Trokendi XR.

For example, in studies, people taking higher doses were more likely to report tingling in the arms or legs, weight loss, and decreased appetite.

Keep in mind that other factors can influence your risk of side effects from Trokendi XR. These factors include your age and other medications you may take.

If you have concerns about your risk of side effects with your dosage of Trokendi XR, talk with your doctor or pharmacist.

To learn more about Trokendi XR’s dosage, see this article.

Can Trokendi cause long-term side effects?

Yes, taking Trokendi may cause long-term side effects. This is rare, though.

Long-term side effects reported by people taking Trokendi XR include:

These side effects could start at any time while you’re taking Trokendi XR. But they aren’t expected to start after treatment ends.

If you’re interested in learning more about Trokendi XR and its long-term side effects, talk with your doctor or pharmacist.

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. The list below includes factors to consider.

Breathing or lung problems. Breathing or lung problems may increase your risk of metabolic acidosis, a rare but serious side effect of Trokendi XR. Examples of such problems include asthma and chronic obstructive pulmonary disease (COPD). If you have lung problems, tell your doctor. They can tell you whether Trokendi XR is safe for you to take.

Depression and suicidal thoughts or behaviors. Depression and suicidal thoughts or behaviors have been reported in people taking Trokendi XR. While these side effects are rare, they are serious. If you have a history of these side effects, you may have a higher risk of experiencing them while taking Trokendi XR. Before you begin taking Trokendi XR, talk with your doctor about your mental health. Your doctor can determine whether the medication is a good treatment option for you.

Eye problems, such as glaucoma. Trokendi XR can cause vision problems, including vision loss and glaucoma, as side effects. If you have existing eye problems, you may be at higher risk of these side effects. Tell your doctor about any eye problems you have. They can tell you whether Trokendi XR is safe for you to take.

History of metabolic acidosis or following a ketogenic diet. Taking Trokendi XR can cause metabolic acidosis as a side effect, although this is rare. If you’ve had this condition in the past, you may be at higher risk for this side effect with Trokendi XR. People who follow a ketogenic diet also have a higher risk of metabolic acidosis if they take Trokendi XR. If you’ve had metabolic acidosis or follow a ketogenic diet, talk with your doctor about whether Trokendi XR is right for you.

Kidney problems. Having kidney problems, such as chronic kidney disease, can increase your risk of several side effects Trokendi XR may cause. These include kidney stones and metabolic acidosis. Tell your doctor about any kidney problems you have. They’ll determine whether Trokendi XR is safe for you to take.

Liver problems. Having liver problems can increase your risk of high ammonia levels in your blood, a potential side effect of Trokendi XR. If you have liver problems, your doctor can tell you whether Trokendi XR is a good treatment option for you.

Weak bones. Metabolic acidosis, a side effect of Trokendi XR, can increase your risk of osteoporosis. If you already have this condition, Trokendi XR may not be safe for you. This is because metabolic acidosis can further weaken your bones. If you start taking this drug, your doctor may monitor your bone strength more closely.

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.

Alcohol and Trokendi XR

You should never drink alcohol 6 hours before or 6 hours after taking Trokendi XR.

Trokendi XR is designed to release a dose slowly over time. Drinking alcohol while taking Trokendi XR can cause the drug to break down all at once in your body. This means the drug won’t work over many hours like it’s supposed to.

Also, drinking alcohol while taking Trokendi XR can cause severe sleepiness, dizziness, and an increase in seizures.

If you have additional questions about drinking alcohol during Trokendi XR treatment, talk with your doctor.

Pregnancy and breastfeeding while taking Trokendi XR

You should not take Trokendi XR during pregnancy. The medication is known to cause fetal harm. Talk with your doctor about safe options to treat your condition while pregnant.

If you become pregnant while taking Trokendi XR, contact your doctor.

Trokendi XR is known to pass into human breast milk. Diarrhea and sleepiness have been reported in infants breastfed by someone who was taking the drug. If you’re breastfeeding or planning to breastfeed, talk with your doctor about safe ways to feed your child during Trokendi XR treatment.

Side effects can happen with Trokendi XR, but they aren’t common.

To learn more about Trokendi XR’s side effects, talk with your doctor or pharmacist. Ask questions to get the answers you need to feel confident about your treatment. Here are a few to get you started:

  • Can other medications I take increase my risk of side effects from Trokendi XR?
  • Will I need to have lab tests to check for Trokendi XR’s side effects?
  • Can my Trokendi XR dose be lowered if I have side effects?

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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.