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Trokendi XR
Trokendi XR is the extended-release version of topiramate, a medication used to treat epilepsy and migraine prevention. It belongs to the class of anticonvulsants and works by reducing abnormal electrical activity in the brain. Trokendi XR is used to help control seizures in patients with epilepsy and to reduce the frequency of migraines. The extended-release formulation allows for once-daily dosing, providing a more consistent release of medication throughout the day.
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Frequently Asked Questions
How long does it take for Trokendi XR to start working?
For seizure control, it may take a few weeks to see the full benefits of Trokendi XR, as doses are often gradually increased. For migraine prevention, noticeable improvements may occur after several weeks of consistent use.
Can I drink alcohol while taking Trokendi XR?
It is advised to avoid alcohol, as it can interfere with the effectiveness of Trokendi XR and increase the risk of side effects like drowsiness. You should avoid alcohol for 6 hours before and after taking the medication.
Can Trokendi XR cause weight loss?
Yes, weight loss is a common side effect of Trokendi XR, especially in individuals taking it for migraine prevention. If significant weight loss occurs, discuss this with your healthcare provider.
What should I do if I miss a dose of Trokendi XR?
If you miss a dose, take it as soon as you remember unless it is close to the time of your next dose. Do not double the dose to make up for a missed one.
Is Trokendi XR safe for long-term use?
Trokendi XR can be used long-term, but regular monitoring by your healthcare provider is important to check for side effects like metabolic acidosis, vision changes, and kidney stones. Routine blood tests may also be required.
Comprehensive Drug Guide
How Does Trokendi XR Work?
- Enhance the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits abnormal brain signals.
- Block certain types of glutamate receptors, which are involved in excitatory brain signals.
- Inhibit certain ion channels that contribute to abnormal electrical activity, reducing the likelihood of seizures and migraines.
Common Dosages
- 25 mg, 50 mg, 100 mg, 200 mg extended-release capsules
Typical Dosing
- For epilepsy: The typical starting dose is 25 mg taken once daily, with the dose gradually increased based on response and tolerance.
- For migraine prevention: The usual starting dose is 25 mg once daily, which may be increased to 100 mg per day.
- Always follow your healthcare provider’s instructions for adjusting the dose.
Typical Dosing
FDA Approved Indications
- Partial-onset seizures in adults and children aged 6 and older
- Primary generalized tonic-clonic seizures in patients aged 6 and older
- Migraine prevention in adults and adolescents aged 12 and older
- Lennox-Gastaut syndrome (a form of epilepsy) in patients aged 6 and older
Who Shouldn't Take Trokendi XR?
- Metabolic acidosis (untreated)
- Known hypersensitivity to topiramate or any components of the formulation
- Patients who have consumed alcohol within 6 hours before or after taking Trokendi XR, as it may affect how the drug is released in the body
Advice From The Pharmacist
- Take Trokendi XR once daily at the same time each day, with or without food.
- Swallow the capsule whole; do not crush or chew, as this may affect the extended-release mechanism.
- Avoid drinking alcohol during treatment and for 6 hours before and after taking the medication, as alcohol can interfere with the drug’s effectiveness.
- Stay hydrated while on Trokendi XR, as it can increase the risk of kidney stones.
- If you miss a dose, take it as soon as you remember unless it’s close to your next scheduled dose. Do not double up doses.
Side Effects of Trokendi XR
Common Side Effects
- Tingling in the hands and feet (paresthesia)
- Loss of appetite and weight loss
- Difficulty concentrating
- Fatigue
- Dizziness
Uncommon/Severe Side Effects
- Metabolic acidosis: A buildup of acid in the body
- Kidney stones
- Vision problems, such as acute myopia or secondary angle closure glaucoma
- Severe allergic reactions (swelling, rash, difficulty breathing)
Risks and Warnings of Trokendi XR
- Cognitive and psychiatric effects: Trokendi XR may cause problems with thinking, memory, concentration, and mood changes, including depression or suicidal thoughts. Alert your healthcare provider if you experience mood changes or unusual behavior.
- Kidney stones: Trokendi XR can increase the risk of developing kidney stones. Drink plenty of water to reduce this risk.
- Vision changes: Trokendi XR can cause serious eye problems like blurred vision or acute angle-closure glaucoma. Contact your doctor immediately if you experience any vision changes.
- Metabolic acidosis: Prolonged use of Trokendi XR can lead to metabolic acidosis, which may affect bone health or growth in children. Routine blood tests may be required to monitor acid levels.
Interactions with Trokendi XR
Common Drug Interactions
- Carbonic anhydrase inhibitors (e.g., acetazolamide): These medications can increase the risk of kidney stones when taken with Trokendi XR.
- Oral contraceptives: Trokendi XR may reduce the effectiveness of birth control pills, leading to an increased risk of pregnancy. Use an alternative or backup contraceptive method.
- CNS depressants: Combining Trokendi XR with medications that affect the central nervous system (such as sedatives or alcohol) can increase the risk of drowsiness and confusion.
Alternatives to Trokendi XR
- Topamax (immediate-release topiramate): A similar medication that requires more frequent dosing, usually twice daily.
- Depakote (valproic acid): Another anticonvulsant used for both epilepsy and migraine prevention.
- Gabapentin: An anticonvulsant used to treat seizures and nerve pain.
- Zonisamide: Another anticonvulsant that may be used in patients with epilepsy.
