Trokendi XR (topiramate) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to:
- help prevent migraine in adults and children ages 12 years and older
- treat epilepsy in adults and children ages 6 years and older who have:
- partial-onset seizures (also called focal seizures)
- primary generalized tonic-clonic seizures
- seizures associated with Lennox-Gastaut syndrome (a rare form of childhood epilepsy)
Trokendi XR is an anticonvulsant medication.
Trokendi XR comes as an extended-release oral capsule. A generic version of Trokendi XR is not currently available.
For information about the dosage of Trokendi XR, including its strengths and how to take the drug, keep reading. For a comprehensive look at Trokendi XR, see this article.
This article describes typical dosages for Trokendi XR provided by the drug’s manufacturer. When taking Trokendi XR, always follow the dosage prescribed by your doctor.
Read on to find information about the usual recommended dosages of Trokendi XR.
Trokendi XR form
Trokendi XR comes as an extended-release oral capsule. These capsules release the medication slowly over the day as they pass through your digestive system.
Trokendi XR strengths
Trokendi XR comes in four strengths: 25 milligrams (mg), 50 mg, 100 mg, and 200 mg.
Typical dosages
Your doctor will typically start you on a low dosage of Trokendi XR. Then, they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for epilepsy
The dosage of Trokendi XR for epilepsy depends on the type of seizures you have and if you take Trokendi XR with other medications.
Dosage when Trokendi XR is taken on its own
Doctors may prescribe Trokendi XR on its own for partial-onset seizures (also called focal seizures) and primary generalized tonic-clonic seizures.
In adults and children ages 10 years and older who are taking Trokendi XR alone for these seizures, the usual recommended dosage is 400 mg once per day. When you first start Trokendi XR treatment, your doctor will typically increase your dosage gradually over a few weeks as follows:
| Week | Daily dosage |
| 1 | 50 mg |
| 2 | 100 mg |
| 3 | 150 mg |
| 4 | 200 mg |
| 5 | 300 mg |
| 6 and beyond | 400 mg |
Increasing your dosage slowly over time allows your body to get used to the medication. This can help you avoid side effects. If you do have bothersome side effects, your doctor may increase your dosage more gradually than the schedule above.
For children ages 6 to 9 years taking Trokendi XR alone for these seizures, the typical recommended dosage is described in “Children’s dosage” below.
Dosage when Trokendi XR is taken with other medications
Doctors may prescribe Trokendi with other medications for partial-onset seizures and primary generalized tonic-clonic seizures. It’s typically prescribed with other medications for seizures associated with Lennox-Gastaut syndrome.
For partial-onset seizures and seizures caused by Lennox-Gastaut syndrome, the usual recommended dosage is 200 mg to 400 mg once per day. This dosage is the same for adults and children ages 17 years and older.
For primary generalized tonic-clonic seizures in adults and children ages 17 years and older, the usual recommended dosage is 400 mg once a day.
When you first start taking Trokendi XR, your doctor will usually increase your dosage gradually over a few weeks. The typical starting dose is 25 mg to 50 mg. This is taken once per day. Your doctor may then increase your daily dosage by 25 mg to 50 mg each week, until the recommended dosage is reached.
Increasing your dosage slowly allows your body to get used to the medication and can help prevent side effects. But if you have bothersome side effects, your doctor may increase your dosage more gradually.
For children ages 6 to 16 years, the recommended dosage of Trokendi XR when taken with other medications for these seizures is described in “Children’s dosage” below.
Dosage for helping prevent migraine episodes
Trokendi XR is approved to help prevent migraine in adults and children ages 12 years and older. The typical recommended dosage for both age groups is 100 mg once per day. When you first start taking the medication, your doctor will likely increase your dosage gradually over a few weeks as follows:
| Week | Daily dosage |
| 1 | 25 mg |
| 2 | 50 mg |
| 3 | 75 mg |
| 4 and beyond | 100 mg |
Increasing your dosage slowly allows your body to get used to the medication and can help you avoid side effects. But if you have bothersome side effects, your doctor may increase your dosage more gradually than the schedule above.
Children’s dosage
The Trokendi XR dosage for children depends on the condition being treated, your child’s age, and their body weight.
Dosage for epilepsy in children
The Trokendi XR dosage for epilepsy depends on the type of seizures the child has and if they take Trokendi XR with other medications.
Dosage when Trokendi XR is taken on its own
Doctors may prescribe Trokendi XR on its own for partial-onset seizures (also called focal seizures) and primary generalized tonic-clonic seizures.
For children ages 10 years and older taking Trokendi XR alone for these seizures, the recommended dosage is the same as for adults. See the “Dosage for epilepsy” section above.
For children ages 6 to 9 years taking Trokendi XR alone for these seizures, the recommended dosage depends on their body weight. For children with a body weight of:
| Body weight in kilograms (kg)* | Body weight in lb | Daily dosage |
| up to 11 | about 25 | 150 mg to 250 mg |
| 12 to 22 | about 26 to 48 | 200 mg to 300 mg |
| 23 to 31 | about 49 to 68 | 200 mg to 350 mg |
| 32 to 38 | about 69 to 83 | 250 mg to 350 mg |
| More than 38 | about 84 and over | 250 mg to 400 mg |
When your child first starts taking Trokendi XR, their doctor will likely increase their dosage gradually over a few weeks.
The typical starting dose is 25 mg. This is taken every day for the first week. For the second week, your child’s doctor will usually increase the dosage to 50 mg taken once per day. Your child’s doctor may then increase the daily dosage by 25 mg to 50 mg each week, until the smallest effective dose is reached.
If needed, their doctor may then keep increasing their dosage by 25 mg to 50 mg each week until the maximum dose is reached. (The maximum dose is the higher end of the recommended dose range in the table above.) But they’ll only do this if the child doesn’t experience bothersome side effects.
*1 kg is approximately 2.2 pounds
Dosage when Trokendi XR is taken with other medications
Doctors may prescribe Trokendi XR with other medications for partial-onset seizures and primary generalized tonic-clonic seizures. Trokendi XR is typically prescribed with other medications for seizures associated with Lennox-Gastaut syndrome.
For these seizures in children ages 6 to 16 years, the typical recommended dosage is 5 mg/kg to 9 mg/kg once per day. For example, for a child weighing 30 kg* (about 66 lb), the recommended dosage is 150 mg to 270 mg once per day.
When your child first starts Trokendi XR treatment, their doctor will usually increase their dosage gradually over a few weeks.
The typical starting dose is 25 mg taken every day for the first week. Your child’s doctor may then increase the daily dose by 1 mg/kg to 3 mg/kg every 1 or 2 weeks. They’ll do this until the smallest effective dose is reached for your child. The maximum dose is 400 mg. This is taken once a day.
*1 kg is approximately 2.2 pounds
Dosage for helping prevent migraine episodes
Trokendi XR is approved to help prevent migraine in children ages 12 years and older. The recommended dosage is the same as for adults. See the “Dosage for epilepsy” section above.
Long-term treatment
Trokendi XR is meant to be taken as a long-term treatment. If you and your doctor determine that Trokendi XR is safe and effective for you, you’ll likely take it long term.
Here are the answers to some frequently asked questions about Trokendi XR dosage.
What’s the dosage for the 50-mg strength of Trokendi XR?
There isn’t a specific dosage for the 50-mg strength of Trokendi XR. The dosage of Trokendi XR your doctor prescribes will depend on several factors, including the condition you take it for and your age.
Depending on the dosage your doctor prescribes, you may take the 50-mg strength of Trokendi alone once per day. Or you might take it with Trokendi XR capsules of other strengths to make up your prescribed daily dose. For example, if your daily dose is 75 mg, your doctor may have you take a 50-mg and a 25-mg capsule.
If you have questions about your dosage of Trokendi XR, talk with your doctor.
What’s the Trokendi XR dosage for weight loss?
There isn’t a specific dosage of Trokendi XR for weight loss. This is because the drug isn’t prescribed for that purpose. But Trokendi XR can cause weight loss in some people.
Your doctor may prescribe Trokendi XR for epilepsy or migraine if weight loss could be beneficial to you. This could be because you have excess weight that raises your risk for other health problems. Or they may prescribe it because you take other medications for seizures or migraine that cause weight gain.
Your doctor will prescribe the dosage that’s recommended for your seizures or migraine.
If you have questions about Trokendi XR and weight loss, talk with your doctor.
If you miss a dose of Trokendi XR, talk with your doctor or pharmacist right away. Depending on how long it’s been since you last took your dose, they may recommend taking the missed dose as soon as possible. If it’s nearly time for your next scheduled dose, they may recommend skipping the missed dose.
You should not take extra doses of Trokendi XR to make up for missed doses.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
The Trokendi XR dosage your doctor prescribes will depend on several factors. These include:
- the type and severity of the condition you’re using Trokendi XR to treat
- your age
- your weight
- your kidney function
- other medications you take
Other medical conditions you have can also affect your Trokendi XR dosage.
Dosage adjustments
When you first start taking Trokendi XR, your doctor will increase your dosage slowly until the dosage that’s right for you is reached.
During treatment your doctor may adjust your dosage for several reasons. These may include:
- bothersome side effects
- change in your child’s age or body weight
- starting or stopping certain other medications
- problems with your kidneys
If you have any questions about your dosage of Trokendi XR, talk with your doctor or pharmacist.
Trokendi XR comes as an oral capsule that you swallow whole.
Trokendi XR should be taken once per day, and you should try to take it at the same time each day. You can take it either with or without food.
The XR in Trokendi XR stands for extended release. With this form, the drug is released slowly over time as the capsule passes through your digestive system. You should not split, crush, or chew the capsule. This can damage its extended-release action, making all the medication release into your body at once. This can cause side effects. It may also mean that you don’t have enough medication in your body to help prevent seizures or migraine episodes later in the day.
It’s important that you don’t take more Trokendi XR than your doctor prescribes. Taking more Trokendi XR than recommended may lead to serious side effects or overdose.
Symptoms of an overdose
Overdose symptoms of Trokendi XR can include:
- drowsiness
- dizziness
- abdominal pain
- blurred or double vision
- trouble speaking or thinking
- agitation
- problems with coordination
- convulsions
- depression
- severe metabolic acidosis (increased acid level in your blood), which may cause rapid breathing and irregular heartbeat
- coma
If you take more than the recommended amount of Trokendi XR
Call your doctor right away if you believe you’ve taken too much of Trokendi XR. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
If you’re taking Trokendi XR to help prevent seizures or migraine, stopping treatment can make your seizures or migraine episodes happen more often. They may also become more severe.
If you have epilepsy, suddenly stopping Trokendi XR can cause you to have seizures that don’t stop. And if you don’t have epilepsy, suddenly stopping Trokendi XR could cause you to have seizures.
You should not stop Trokendi XR unless you talk with your doctor first. If you and your doctor decide you should stop treatment, this is typically done gradually. Your doctor will explain how to reduce your dosage of Trokendi XR slowly to help lower your risk for seizures.
The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Trokendi XR for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Trokendi XR without your doctor’s recommendation. If you have questions about the dosage of Trokendi XR that’s right for you, talk with your doctor.
Besides learning about dosage, you may want other information about Trokendi XR. These additional articles might be helpful to you:
- More about Trokendi XR. For information about other aspects of Trokendi XR, refer to this article.
- Drug comparison. You can check out how Trokendi XR compares with Topamax and Depakote.
- Details about your condition. For details about migraine, our headache & migraine hub might be helpful, as well as these related articles. For details about seizures, see our epilepsy & seizures hub and these related articles.
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.
