Trokendi XR (topiramate) is a prescription brand-name medication. It’s approved by the Food and Drug Administration (FDA) for:

Trokendi XR is typically taken as a long-term treatment.

Here are some fast facts about Trokendi XR:

  • Active ingredient: topiramate
  • Drug class: anticonvulsants
  • Drug form: oralextended-release capsule

Like other drugs, Trokendi XR can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Trokendi XR, including details about its uses, see this article.

Trokendi XR can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Keep in mind that common side effects of Trokendi XR can vary depending on which condition the drug is being taken for.

Trokendi XR is an extended-release* form of the active drug topiramate. The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as immediate-release* forms of topiramate.

These are just a few of the more common side effects reported by people who took immediate-release topiramate in clinical trials:

  • paresthesia (tingling or burning sensations)
  • loss of appetite
  • fatigue
  • trouble remembering or concentrating
  • weight loss†

* Extended-release forms release the medication slowly over several hours as they pass through your digestive system. Immediate-release forms release the drug all at once when they dissolve.
† For more information about this side effect, see the “Side effect specifics” section below.

Mild side effects can occur with Trokendi XR. This list doesn’t include all possible mild side effects of the drug. For more information, refer to Trokendi XR’s prescribing information.

Trokendi XR is an extended-release* form of the active drug topiramate. The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as immediate-release* forms of topiramate.

Mild side effects that have been reported with immediate-release topiramate include:

  • numbness or paresthesia (tingling or burning sensations)
  • loss of appetite
  • sleepiness or fatigue (low energy)
  • dizziness
  • trouble remembering or concentrating
  • slowed reactions
  • problems with speech, such as trouble finding the right words
  • upper respiratory infection, such as the common cold
  • nervousness or anxiety
  • fever
  • nausea
  • abdominal pain
  • diarrhea or constipation
  • altered sense of taste
  • weakness
  • problems with coordination
  • trouble sleeping
  • weight loss†
  • hair loss†

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Trokendi XR and want to tell the FDA about it, visit MedWatch.

* Extended-release forms release the medication slowly over several hours as they pass through your digestive system. Immediate-release forms release the drug all at once when they dissolve.
† For more information about this side effect, see the “Side effect specifics” section below.

Trokendi XR may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, refer to Trokendi XR’s prescribing information.

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.

Trokendi XR is an extended-release (XR)* form of the active drug topiramate. The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as immediate-release (IR)* forms of topiramate.

Serious side effects that have been reported with immediate-release topiramate and their symptoms include:

* XR forms release the medication slowly over several hours as they pass through your digestive system. IR forms release the drug all at once when they dissolve.
† For more information about this side effect, see the “Side effect specifics” section below.
‡ An allergic reaction is possible after taking Trokendi XR. However, this side effect wasn’t reported in clinical trials.

Trokendi XR may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Can Trokendi XR’s side effects vary based on which dose I take (25 mg, 50 mg, 100 mg, 200 mg)?

They might. As with many medications, you may be more likely to have certain side effects with higher doses of Trokendi XR than with lower doses. For example, side effects that are more common with higher doses include tingling or burning sensations, fatigue, slowed reactions, and dizziness. Weight loss, trouble concentrating, speech problems, and mood problems such as depression are also more common with higher doses.

Higher doses of Trokendi XR are used for treating epilepsy, while lower doses are used for helping prevent migraine. In both cases, your doctor will gradually increase your dose over a few weeks when you start treatment. This allows your body to get used to the medication and can help reduce the risk of side effects. If you have bothersome side effects after a dose increase, your doctor may raise your dose more slowly than usual. Or they may lower your dose again.

If you’re concerned about the risk of side effects with the dose of Trokendi XR your doctor recommends, discuss this with them.

Are there any long-term side effects of Trokendi XR?

No, there aren’t really any long-term side effects. However, some serious side effects could lead to long-term problems if they’re not treated. For example, Trokendi XR can sometimes cause a serious side effect called glaucoma (rising pressure in the eye). If this isn’t treated, it could lead to permanent blindness.

Most of Trokendi XR’s side effects are temporary. They typically get better either during treatment or soon after you stop taking the medication.

Also, taking Trokendi XR for long periods doesn’t seem to increase the risk of developing side effects.

If you have questions about possible long-term side effects with Trokendi XR, talk with your doctor.

Will Trokendi XR affect my ability to drive?

It’s possible. Trokendi XR can cause various side effects that might make driving dangerous. For example, some people taking the medication may experience:

  • sleepiness
  • fatigue
  • dizziness
  • trouble remembering or concentrating
  • confusion
  • slowed reactions
  • problems with coordination
  • changes in vision, such as blurred vision or partial loss of vision

However, not everyone taking Trokendi XR will experience these side effects. It’s important to see how the medication affects you before you drive.

When you start taking Trokendi XR, your doctor will gradually increase your dosage over a few weeks. You should not consider driving until you reach the dosage recommended by your doctor. If you don’t have any of the side effects mentioned above at this stage, talk with your doctor about whether it’s safe for you to drive.

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

Weight loss

Trokendi XR* can reduce appetite, and over time this may lead to weight loss. In fact, weight loss was one of the most common side effects† reported in clinical trials of immediate-release (IR)* topiramate.

Weight loss may be more common with higher doses of Trokendi XR.

Weight loss may benefit some people. For example, your doctor may recommend Trokendi XR if you have excess weight that increases your risk of additional health problems. They may also recommend the drug if you take other seizure or migraine treatments that can cause weight gain. However, Trokendi XR should not be taken solely for weight loss.

* Trokendi XR is an extended-release (XR) form of the active drug topiramate. XR forms release the medication slowly over several hours as they pass through your digestive system. IR forms release the drug all at once when they dissolve.
† The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as IR forms of topiramate.

What you can do

If you’re concerned about weight loss with Trokendi XR, talk with your doctor. They can give you advice on ways to maintain a moderate weight.

Hair loss

Trokendi XR* may cause hair loss or hair thinning in some people. But in clinical trials, this side effect† wasn’t common in people who took immediate-release (IR)* topiramate for epilepsy. Hair loss and hair thinning also weren’t reported in people who took IR topiramate for migraine.

If you have hair loss with Trokendi XR, this is usually reversible. Any hair you lose is expected to grow back after you stop taking the drug.

* Trokendi XR is an extended-release (XR) form of the active drug topiramate. XR forms release the medication slowly over several hours as they pass through your digestive system. IR forms release the drug all at once when they dissolve.
† The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as IR forms of topiramate.

What you can do

To minimize any hair loss while taking Trokendi XR, it may help to avoid harsh hair treatments and styling. This includes perms, coloring, and pulling hair back into tight styles.

If you’re concerned about hair loss with Trokendi XR, talk with your doctor. They may suggest other ways to help prevent hair loss, such as taking vitamin supplements. If you have bothersome hair loss while taking Trokendi XR, your doctor may also recommend a different medication to help prevent seizures or migraine.

Eye or vision problems

Some people may have eye or vision problems with Trokendi XR.* For example, Trokendi XR can sometimes cause blurry vision, double vision, or partial loss of vision.† The drug can also cause a condition called secondary angle-closure glaucoma. With this condition, pressure in your eye rises suddenly. It can lead to permanent blindness if it’s not treated quickly.

Symptoms of secondary angle-closure glaucoma occur rapidly and may include:

  • blurry vision
  • loss of vision
  • eye pain
  • eye redness
  • dilated pupils

It’s not known how often secondary angle-closure glaucoma occurred in clinical trials of immediate-release (IR)* topiramate, but it wasn’t common. If the condition develops, it’s most likely to happen in the first month after starting treatment with Trokendi XR.

* Trokendi XR is an extended-release (XR) form of the active drug topiramate. XR forms release the medication slowly over several hours as they pass through your digestive system. IR forms release the drug all at once when they dissolve.
† The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as IR forms of topiramate.

What you can do

If you have any symptoms of glaucoma or other changes in your vision while taking Trokendi XR, see your doctor right away.

Your doctor may refer you to an eye specialist so they can check the pressure in your eyes. If you have glaucoma, you’ll likely need to stop taking Trokendi XR. You may also need treatment to help reduce the pressure. If you have other vision problems, your doctor will also likely recommend that you stop taking Trokendi XR.

If your doctor recommends that you stop Trokendi XR treatment, you’ll usually need to do so gradually. Tapering off the medication may help prevent seizures or migraine from getting worse. Your doctor may also recommend that you start a different treatment for your condition. It’s important to follow your doctor’s instructions if you need to stop taking Trokendi XR.

Keep in mind that eye and vision problems typically get better after stopping Trokendi XR treatment.

Metabolic acidosis

Trokendi XR* can sometimes increase the level of acid in your blood. This potentially serious side effect† is called metabolic acidosis. If this side effect isn’t treated, it can lead to weak or brittle bones and kidney stones. In children, metabolic acidosis can also lead to slowed growth.

Metabolic acidosis was commonly reported in clinical trials of immediate-release (IR)* topiramate. However, this side effect was usually mild to moderate. Rarely, it was severe.

Symptoms of metabolic acidosis can include:

  • fatigue
  • loss of appetite
  • fast breathing
  • irregular heartbeat
  • trouble thinking clearly

It’s also possible to have metabolic acidosis without any symptoms.

* Trokendi XR is an extended-release (XR) form of the active drug topiramate. XR forms release the medication slowly over several hours as they pass through your digestive system. IR forms release the drug all at once when they dissolve.
† The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as IR forms of topiramate.

What you can do

Your doctor will check the level of acid in your blood before you start Trokendi XR treatment. They’ll also check it from time to time while you take the medication. If you have symptoms of metabolic acidosis, see your doctor right away.

If you have metabolic acidosis, your doctor will likely recommend a treatment for it, such as sodium bicarbonate. They may also decrease your dose of Trokendi XR. If these options don’t help, your doctor may recommend switching to a different treatment.

Allergic reaction

As with most drugs, Trokendi XR* can cause an allergic reaction in some people. But this side effect† wasn’t reported in clinical trials of immediate-release (IR)* topiramate.

Symptoms of an allergic reaction can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

* Trokendi XR is an extended-release (XR) form of the active drug topiramate. XR forms release the medication slowly over several hours as they pass through your digestive system. IR forms release the drug all at once when they dissolve.
† The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as IR forms of topiramate.

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Trokendi XR. If your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Depression and suicidal thoughts or actions

Trokendi XR can sometimes cause or worsen depression. As with other anticonvulsant drugs, Trokendi XR can also increase your risk of suicidal thoughts or actions. However, in clinical trials of people taking anticonvulsant drugs for any use, suicidal thoughts and actions were rare.

Symptoms of new or worsening depression may include:

  • feelings of sadness or hopelessness that don’t go away
  • loss of interest in usual activities
  • trouble sleeping or sleeping too much
  • panic attacks or anxiety
  • agitation or restlessness
  • irritable, aggressive, or violent behavior
  • other changes in your mood or behavior
  • thoughts of suicide or self-harm

What you can do

It’s important for you and the people close to you to watch for any changes in your mood or behavior while you take Trokendi XR.

If you develop symptoms of depression or notice any other changes in your mood or behavior, talk with your doctor right away. They may suggest ways to treat these problems. Or they may recommend switching to a different treatment to help prevent your seizures or migraine.

If you have suicidal thoughts, it’s important to get help right away.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Most side effects of Trokendi XR* are similar in children and adults who take the drug.† Examples of these side effects are mentioned above.

However, certain side effects may be more common in children. These include:

If your child takes Trokendi XR, it’s important to keep a close eye on them in hot weather and when they exercise vigorously. If your child sweats less than usual or has a high temperature, talk with their doctor right away. These problems can lead to hyperthermia, which may require treatment in a hospital. (Hyperthermia refers to conditions in which body temperature is high.) For children ages 6 years and older, a temperature higher than 99.5°F (37.5°C) taken orally is considered high.

Some side effects of Trokendi XR are less in common in children than in adults who take the medication. These include:

  • trouble remembering or concentrating
  • slowed reactions
  • problems with speech, such as trouble finding the right words

If you have questions about possible side effects of Trokendi XR in children, talk with your doctor.

* Trokendi XR is an extended-release (XR) form of the active drug topiramate. XR forms release the medication slowly over several hours as they pass through your digestive system. Immediate-release (IR) forms release the drug all at once when they dissolve.
† The side effects of Trokendi XR haven’t been specifically studied. However, the drug is expected to cause the same side effects as IR forms of topiramate.

Be sure to talk with your doctor about your health history before you take Trokendi XR. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Weak, soft, or brittle bones. Trokendi XR can sometimes cause a side effect called metabolic acidosis. If this goes untreated, it can lead to conditions such as osteoporosis or osteomalacia. If you already have weak, soft, or brittle bones, you could have an increased risk of developing these conditions. Ask your doctor if Trokendi XR is right for you. If you take the drug, you may need extra blood tests to check the level of acid in your blood.

Kidney problems. If you have kidney problems, you may have an increased risk of kidney stones and metabolic acidosis with Trokendi XR. Ask your doctor if this drug is right for you. If they prescribe Trokendi XR, you may need additional tests to monitor your kidney health and the level of acid in your blood.

Lung problems. If you have severe lung or breathing problems, you may have an increased risk of metabolic acidosis with Trokendi XR. Examples of these problems include chronic obstructive pulmonary disease (COPD) and asthma. Ask your doctor if Trokendi XR is right for you. If you take the medication, you may need more blood tests to monitor the level of acid in your blood.

Liver problems. If you have liver problems, you may have an increased risk of hyperammonemia (high level of ammonia in your blood) with Trokendi XR. Ask your doctor if the medication is right for you. If you take Trokendi XR, you may need extra blood tests to monitor the level of ammonia in your blood.

Diarrhea. If you have frequent or long-term diarrhea, you may have an increased risk of metabolic acidosis with Trokendi XR. Ask your doctor if this medication is right for you. If you have diarrhea while taking Trokendi XR, tell your doctor. They may check the level of acid in your blood.

Ketogenic diet. If you follow a ketogenic diet, you may have an increased risk of metabolic acidosis and kidney stones with Trokendi XR. A ketogenic diet is high in fat and low in carbohydrates. The diet is sometimes recommended for people with epilepsy that’s not well managed with medication. If you follow a ketogenic diet or want to try one, Trokendi XR may not be right for you. You can discuss this with your doctor.

Eye problems, such as glaucoma. Trokendi XR can sometimes causeeye problems, includingsecondary angle-closure glaucoma. If you already have eye problems, especially glaucoma, ask your doctor if Trokendi XR is right for you.

Mental health problems, such as depression. Trokendi XR can cause or worsen depression and increase the risk of suicidal thoughts and actions. If you have a history of mental health problems such as depression, you may have an increased risk of this side effect. Ask your doctor if Trokendi XR is right for you. If you take the drug, talk with your doctor right away if you have any changes in your mood or behavior or thoughts about suicide.

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 them what other medications may be better options for you.

Other medications. If you take certain other medications, they may increase your risk of certain side effects with Trokendi XR. Be sure to tell your doctor about all the medications you take, including herbal remedies and over-the-counter drugs.

Alcohol and Trokendi XR

You should not drink alcohol in the 6 hours before and after taking Trokendi XR.

Trokendi XR is an extended-release drug. This means that the medication is usually released slowly over several hours as it passes through your digestive system. The slow release provides a steady level of Trokendi XR in your blood throughout the day.

However, the capsule can break down if you drink alcohol in the 6 hours before or after you take Trokendi XR. When the capsule breaks down, all the medication may be released at once. This can increase the risk of side effects. It also means you may not have enough medication in your body to help prevent seizures or migraine episodes later in the day.

If you’re concerned about avoiding alcohol before and after taking Trokendi XR, talk with your doctor.

Pregnancy and breastfeeding while taking Trokendi XR

Here’s some information about pregnancy, breastfeeding, and Trokendi XR.

Pregnancy. Taking Trokendi XR during pregnancy may harm a developing fetus. The medication can increase the risk of the child being born with a cleft lip or cleft palate. Trokendi can also increase the risk of the child being born small for their gestational age. (The term “gestational age” refers to how long the fetus was in the uterus.)

If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of taking Trokendi XR.

If you decide to take Trokendi XR during pregnancy, consider signing up with the North American Antiepileptic Drug Pregnancy Registry. This registry helps healthcare professionals collect information about the safety of medications, such as Trokendi XR, during pregnancy. The registry can help people make informed decisions about the treatments they have during pregnancy.

Breastfeeding. Trokendi XR can pass into breast milk. The drug could cause side effects such as sleepiness and diarrhea in a child who’s breastfed.

If you’re breastfeeding or plan to breastfeed, talk with your doctor about the possible risks and benefits of taking Trokendi XR. If you decide to take the medication, they can advise you on the best way to feed your child.

Like many other medications for epilepsy and migraine, Trokendi XR can commonly cause side effects. These are mainly mild and tend to improve after a few days to weeks as your body gets used to the medication. However, some serious side effects are also possible.

Be sure to talk with your doctor if you develop mild side effects that are bothersome or don’t go away. You should also let them know if you have serious side effects.

If you’d like to learn more about Trokendi XR, talk with your doctor or pharmacist. They can help answer any questions you may have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

Disclaimer: Medical News Today 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.