Trokendi XR: A Complete Overview

Trokendi XR is a once-daily, extended-release capsule containing Topiramate, an anticonvulsant medication used to treat epilepsy and prevent migraines.

Manufactured by Supernus Pharmaceuticals, Trokendi XR delivers Topiramate slowly over 24 hours, which means you only take it once a day instead of twice (as with immediate-release Topiramate). This guide covers everything you need to know — what it treats, how to take it, who should avoid it, and what it costs in 2026.

What Is Trokendi XR?

Trokendi XR belongs to a class of drugs called anticonvulsants (also known as antiepileptic drugs or AEDs). Its active ingredient, Topiramate, works through multiple mechanisms in the brain: it blocks voltage-dependent sodium channels, enhances GABA activity, antagonizes certain glutamate receptors, and inhibits carbonic anhydrase enzymes. Together, these actions reduce abnormal electrical activity that causes seizures and migraines.

To learn more about how these mechanisms work in plain English, see our article on how Trokendi XR works.

Trokendi XR is available as extended-release capsules in four strengths: 25 mg, 50 mg, 100 mg, and 200 mg.

What Is Trokendi XR Used For?

Trokendi XR is FDA-approved for the following conditions:

• Partial onset seizures — In adults and children ages 6 and older. Can be used alone (monotherapy) or with other seizure medications (adjunctive therapy).
• Primary generalized tonic-clonic seizures — In adults and children ages 6 and older, as adjunctive therapy.
• Lennox-Gastaut syndrome — As adjunctive therapy for seizures in adults and children ages 6 and older.
• Migraine prevention — In adults and adolescents ages 12 and older. Note: Trokendi XR is for preventing migraines, not treating them once they've started.

Topiramate is also used off-label for alcohol dependence, binge eating disorder, essential tremor, and weight management, though Trokendi XR specifically is not FDA-approved for these uses.

How Is Trokendi XR Taken?

Trokendi XR is taken once daily, with or without food. Key instructions:

• Swallow capsules whole. Do not split, crush, chew, or sprinkle on food. (This is different from Qudexy XR, which can be sprinkled.)
• Avoid alcohol within 6 hours before and 6 hours after taking your dose. Alcohol can alter how Trokendi XR releases the medication, leading to unpredictable blood levels.
• Start low, go slow. Your doctor will typically start you at 25 mg daily and increase the dose gradually over several weeks. The target dose depends on your condition and can range from 100 mg to 400 mg daily.
• Take it at the same time each day to maintain consistent blood levels.

Who Should Not Take Trokendi XR?

Trokendi XR is not right for everyone. You should avoid it or use it with extreme caution if:

• You have a known allergy to Topiramate or any ingredient in Trokendi XR.
• You have consumed or plan to consume alcohol within 6 hours of taking it.
• You are pregnant or planning to become pregnant. Trokendi XR is Pregnancy Category D — it can cause birth defects, specifically cleft lip and palate. If you become pregnant while taking it, contact your doctor immediately.
• You have metabolic acidosis and are taking Metformin.
• You have kidney stones or a history of them — Topiramate increases the risk.
• You have liver or kidney disease — dose adjustments may be needed.

Always give your doctor a complete list of your medications. Trokendi XR has several important drug interactions that your prescriber needs to know about.

How Much Does Trokendi XR Cost?

Trokendi XR is not cheap. Without insurance, the brand-name medication costs approximately $1,200 to $1,400 per month.

Here's how to manage the cost:

• Insurance with prior authorization — Many plans cover Trokendi XR but require prior authorization and may require you to try generic Topiramate IR first (step therapy).
• Manufacturer savings card — Supernus Pharmaceuticals offers a copay savings card for commercially insured patients.
• Patient assistance programs — The Supernus Cares program helps uninsured or underinsured patients. Also check NeedyMeds and RxAssist.
• Generic alternatives — Generic Topiramate IR tablets cost as little as $10-$30/month. Qudexy XR is another extended-release option. See our alternatives guide.
• Coupon cards — GoodRx, SingleCare, and other discount programs may lower your price at certain pharmacies.

For a detailed breakdown of all savings options, read our complete savings guide for Trokendi XR.

Final Thoughts

Trokendi XR is an effective once-daily option for managing epilepsy and preventing migraines. Its extended-release formulation offers the convenience of once-daily dosing, but comes with a higher price tag and some unique considerations — like the strict alcohol avoidance rule and the requirement to swallow capsules whole.

If you've been prescribed Trokendi XR and need help finding it at a pharmacy near you, Medfinder can show you which pharmacies have it in stock. And if you're just getting started, our guide on finding a doctor who prescribes Trokendi XR can help you take the first step.