Trokendi XR

Last updated on RxList: 7/18/2021
Trokendi XR Side Effects Center

What Is Trokendi?

Trokendi XR (topiramate) Extended-release is a sulfamate-substituted monosaccharide used as initial monotherapy in patients 10 years of age and older with partial onset or primary generalized tonic-clonic seizures and adjunctive therapy in patients 6 years of age and older with partial onset or primary generalized tonic-clonic seizures.

What Are Side Effects of Trokendi?

Common side effects of Trokendi XR include:

A small percent of patients taking Trokendi XR may experience suicidal ideation. If you have thoughts of suicide, tell your doctor immediately.

Dosage for Trokendi

The recommended dose for Trokendi XR monotherapy in adults and pediatric patients 10 years of age and older is 400 mg orally once daily.

What Drugs, Substances, or Supplements Interact with Trokendi?

Trokendi XR may interact with alcohol, oral contraceptives, antiepileptic drugs, CNS depressants, carbonic anhydrase inhibitors, metformin, and lithium. Tell your doctor all medications and supplements you use.

Trokendi During Pregnancy and Breastfeeding

Trokendi XR may harm a fetus. Use of birth control is recommended while using this drug. Since Trokendi XR may affect hormonal birth control, discuss forms of birth control with your doctor. It is unknown if Trokendi XR could harm a nursing infant and caution should be used. Consult your doctor before breastfeeding. Antiepileptic drugs including Trokendi XR should be gradually withdrawn to minimize the potential for seizures or increased seizure frequency.

Additional Information

Our Trokendi XR (topiramate) Extended-release Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Trokendi XR Consumer Information

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Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Report any new or worsening mood symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • a skin rash, no matter how mild;
  • vision problems, blurred vision, eye pain or redness, sudden vision loss (can be permanent if not treated quickly);
  • confusion, problems with thinking or memory, trouble concentrating, problems with speech;
  • dehydration symptoms--decreased sweating, high fever, hot and dry skin;
  • signs of a kidney stone--severe pain in your side or lower back, painful or difficult urination;
  • signs of too much acid in your blood--irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath; or
  • signs of too much ammonia in your blood--vomiting, unexplained weakness, feeling like you might pass out.

Common side effects may include:

  • dizziness, drowsiness, tired feeling, slow reactions;
  • problems with speech or memory;
  • abnormal vision;
  • numbness or tingling in your arms and legs, decreased sensation (especially in the skin);
  • changes in your sense of taste;
  • feeling nervous;
  • nausea, diarrhea, stomach pain, loss of appetite;
  • fever, weight loss; or
  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Trokendi XR (Topiramate Extended-release Capsules)

QUESTION

If you have had a seizure, it means you have epilepsy. See Answer
Trokendi XR Professional Information

SIDE EFFECTS

The following serious adverse reactions are discussed in more detail in other sections of the labeling:

  • Acute Myopia and Secondary Angle Closure Glaucoma [see WARNINGS AND PRECAUTIONS]
  • Visual Field Defects [see WARNINGS AND PRECAUTIONS]
  • Oligohydrosis and Hyperthermia [see WARNINGS AND PRECAUTIONS]
  • Metabolic Acidosis [see WARNINGS AND PRECAUTIONS]
  • Suicidal Behavior and Ideation [see WARNINGS AND PRECAUTIONS]
  • Cognitive/Neuropsychiatric Adverse Reactions [see WARNINGS AND PRECAUTIONS]
  • Withdrawal of Antiepileptic Drugs [see WARNINGS AND PRECAUTIONS]
  • Serious Skin Reactions [see WARNINGS AND PRECAUTIONS]
  • Hyperammonemia and Encephalopathy (Without and With Concomitant Valproic Acid Use) [see WARNINGS AND PRECAUTIONS]
  • Kidney Stones [see WARNINGS AND PRECAUTIONS]
  • Hypothermia With Concomitant Valproic Acid Use [see WARNINGS AND PRECAUTIONS]

The data described in the following sections were obtained using immediate-release topiramate tablets. TROKENDI XR® has not been studied in a randomized, placebo-controlled Phase III clinical study; however, it is expected that TROKENDI XR® would produce a similar adverse reaction profile as immediate-release topiramate.

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug, and may not reflect the rates observed in practice.

Monotherapy Epilepsy

Adults 16 Years of Age and Older

The most common adverse reactions in the controlled trial (Study 1) that occurred in adults in the 400 mg/day topiramate group and at an incidence higher (≥ 10%) than in the 50 mg per day group were: paresthesia, weight loss, and anorexia (see Table 3).

Approximately 21% of the 159 adult patients in the 400 mg/day group who received topiramate as monotherapy in Study 1 discontinued therapy due to adverse reactions. The most common (≥ 2% more frequent than low-dose 50 mg/day topiramate) adverse reactions causing discontinuation were difficulty with memory, fatigue, asthenia, insomnia, somnolence, and paresthesia.

Pediatric Patients 6 Years to 15 Years of Age

The most common adverse reactions in the controlled trial (Study 1) that occurred in pediatric patients in the 400 mg/day topiramate group and at an incidence higher (≥ 10%) than in the 50 mg/day group were fever and weight loss (see Table 3).

Approximately 14% of the 77 pediatric patients in the 400 mg/day group who received topiramate as monotherapy in the controlled clinical trial discontinued therapy due to adverse reactions. The most common (≥ 2% more frequent than in the 50 mg/day group) adverse reactions resulting in discontinuation in this trial were difficulty with concentration/attention, fever, flushing, and confusion.

Table 3 represents the incidence of adverse reactions occurring in at least 3% of adult and pediatric patients treated with 400 mg/day immediate-release topiramate and occurring with greater incidence than 50 mg/day topiramate.

Table 3: Adverse Reactions in the High Dose Group as Compared to the Low Dose Group, in Monotherapy Epilepsy Trial in Adult and Pediatric Patients

Body System/ Adverse ReactionAge Group
Pediatric
(6 to 15 Years)
Adult
(Age ≥16 Years)
Immediate-release Topiramate Daily
Dosage Group (mg/day)
5040050400
(N=74)
%
(N=77)
%
(N=160)
%
(N=159)
%
Body as a Whole-General Disorders
  Asthenia0346
  Fever112
  Leg pain23
Central & Peripheral Nervous System Disorders
  Paresthesia3122140
  Dizziness1314
  Ataxia34
  Hypoesthesia45
  Hypertonia03
  Involuntary Muscle contraction03
  Vertigo03
Gastro-intestinal System Disorders
  Constipation14
  Diarrhea89
  Gastritis03
  Dry mouth13
Liver and Biliary System Disorders
  Increase in Gamma-GT13
Metabolic and Nutritional Disorders
  Weight loss717617
Platelet, Bleeding & Clotting Disorders
  Epistaxis04
Psychiatric Disorders
  Anorexia414
  Anxiety46
  Cognitive problems1614
  Confusion03
  Depression0379
  Difficulty with concentration or attention71078
  Difficulty with memory13611
  Insomnia89
  Decrease in libido03
  Mood problems1825
  Personality disorder (behavior problems)03
  Psychomotor slowing35
  Somnolence1015
Red Blood Cell Disorders
  Anemia13
Reproductive Disorders, Female
  Intermenstrual bleeding03
  Vaginal hemorrhage03
Resistance Mechanism Disorders
  Infection3823
  Viral infection3668
Respiratory System Disorders
  Bronchitis1534
  Upper respiratory tract infection1618
  Rhinitis5624
  Sinusitis14
Skin and Appendages Disorders
  Alopecia1434
  Pruritus14
  Rash3414
  Acne23
Special Senses Other, Disorders
  Taste perversion35
Urinary System Disorders
  Cystitis13
  Micturition frequency0302
  Renal calculus03
  Urinary incontinence13
Vascular (Extracardiac) Disorders
  Flushing05

Adjunctive Therapy Epilepsy

Adults 16 Years of Age and Older

In pooled controlled clinical trials in adults with partial-onset seizures, primary generalized tonic-clonic seizures, or Lennox-Gastaut syndrome, 183 patients received adjunctive therapy with immediate-release topiramate at dosages of 200 to 400 mg/day (recommended dosage range), and 291 patients received placebo. Patients in these trials were receiving 1 to 2 concomitant antiepileptic drugs in addition to immediate-release topiramate or placebo.

The most common adverse reactions in the controlled clinical trial that occurred in adult patients in the 200-400 mg/day topiramate group with an incidence higher (≥10%) than in the placebo group were: dizziness, speech disorders/related speech problems, somnolence, nervousness, psychomotor slowing, and vision abnormal (see Table 4) [see Clinical Studies].

Table 4 presents the incidence of adverse reactions occurring in at least 3% of adult patients treated with 200 to 400 mg/day topiramate and was greater than placebo incidence. The incidence of some adverse reactions (e.g., fatigue, dizziness, paresthesia, language problems, psychomotor slowing, depression, difficulty with concentration/attention, mood problems) was dose-related and much greater at higher than recommended topiramate dosing (i.e., 600 to 1000 mg/day) compared to the incidence of these adverse reactions at the recommended dosing (200 to 400 mg/day) range.

Table 4: Most Common Adverse Reactions in Pooled Placebo-Controlled, Adjunctive Epilepsy Trials in Adults *,

Body System/
Adverse Reaction
Placebo
(N=291)
%
Topiramate
Dosage (mg/day)
200-400
(N=183)
%
Body as a Whole-General Disorders
Fatigue1315
Asthenia16
Back pain45
Chest pain34
Influenza-like symptoms23
Central & Peripheral Nervous System Disorders
Dizziness1525
Ataxia716
Speech disorders/Related speech problems213
Paresthesia411
Nystagmus710
Tremor69
Language problems16
Coordination abnormal24
Gait abnormal13
Gastro-Intestinal System Disorders
Nausea810
Dyspepsia67
Abdominal pain46
Constipation24
Metabolic and Nutritional Disorders
Weight loss39
Psychiatric Disorders
Somnolence1229
Nervousness616
Psychomotor slowing213
Difficulty with memory312
Confusion511
Anorexia410
Difficulty with concentration/attention26
Mood problems24
Agitation23
Aggressive reaction23
Emotional liability13
Cognitive problems13
Reproductive Disorders, Female
Breast pain24
Respiratory System Disorders
Rhinitis67
Pharyngitis26
Sinusitis45
Vision Disorders
Vision abnormal213
Diplopia510
* Patients in these adjunctive trials were receiving 1 to 2 concomitant antiepileptic drugs in addition to topiramate or placebo
Values represent the percentage of patients reporting a given reaction. Patient may have reported more than one adverse reaction during the study and can be included in more than one adverse reaction category.

In controlled clinical trials in adults, 11% of patients receiving immediate-release topiramate 200 to 400 mg per day as adjunctive therapy discontinued due to adverse reactions. This rate appeared to increase at dosages above 400 mg per day. Adverse reactions associated with discontinuing therapy included somnolence, dizziness, anxiety, difficulty with concentration or attention, fatigue, and paresthesia.

Pediatric Patients 2 to 15 Years of Age

In pooled, controlled clinical trials in pediatric patients (2 to 15 years of age) with partial-onset seizures, primary generalized tonic-clonic seizures, or Lennox-Gastaut syndrome, 98 patients received adjunctive therapy with immediate-release topiramate at dosages of 5 mg to 9 mg/kg/day (recommended dosage range) and 101 patients received placebo.

The most common adverse reactions in the controlled clinical trial that occurred in pediatric patients in the 5 mg to 9 mg/kg/day immediate-release topiramate group with an incidence higher (≥10%) than in the placebo group were: fatigue and somnolence (see Table 5).

Table 5 presents the incidence of adverse reactions that occurred in at least 3% of pediatric patients 2 to 15 years of age receiving 5 mg to 9 mg/kg/day (recommended dosage range) of immediate-release topiramate and was greater than placebo incidence.

Table 5: Adverse Reactions in Pooled Placebo-Controlled, Adjunctive Epilepsy Trial in Pediatric Patients 2 to 15 Years of Age*,

Body System/
Adverse Reaction
Placebo
(N=101)
%
Topiramate
(N=98)
%
Body as a Whole-General Disorders
Fatigue516
Injury1314
Central & Peripheral Nervous System Disorders
Gait abnormal58
Ataxia26
Hyperkinesia45
Dizziness24
Speech disorders/Related speech problems24
Gastro-Intestinal System Disorders
Nausea56
Saliva increased46
Constipation45
Gastroenteritis23
Metabolic and Nutritional Disorders
Weight loss19
Platelet, Bleeding & Clotting Disorders
Purpura48
Epistaxis14
Psychiatric Disorders
Somnolence1626
Anorexia1524
Nervousness714
Personality disorder (Behavior Problems)911
Difficulty with concentration/attention210
Aggressive reaction49
Insomnia78
Difficulty with memory05
Confusion34
Psychomotor slowing23
Resistance Mechanism Disorders
Infection viral37
Respiratory System Disorders
Pneumonia15
Skin and Appendages Disorders
Skin Disorder23
Urinary System Disorders
Urinary incontinence24
* Patients in these adjunctive trials were receiving 1 to 2 concomitant antiepileptic drugs in addition to topiramate or placebo
Values represent the percentage of patients reporting a given adverse reaction. Patients may have reported more than one adverse reaction during the study and can be included in more than one adverse reaction category

None of the pediatric patients who received topiramate adjunctive therapy at 5 mg/kg/day to 9 mg/kg/day in controlled clinical trials discontinued due to adverse reactions.

Migraine

Adults

In the four multicenter, randomized, double-blind, placebo-controlled, parallel group clinical trials for the preventive treatment of migraine (which included 35 pediatric patients 12 to 15 years of age), most adverse reactions occurred more frequently during the titration period than during the maintenance period.

The most common adverse reactions with immediate-release topiramate 100mg in the clinical trials for the preventive treatment of migraine of predominantly adults that were seen at an incidence higher (≥5%) than in the placebo group were: paresthesia, anorexia, weight loss, taste perversion, diarrhea, difficulty with memory, hypoesthesia, and nausea (see Table 6).

Table 6 includes those adverse reactions that occurred in the placebo-controlled trials where the incidence in any immediate-release topiramate group was at least 3% and was greater than that for placebo patients. The incidence of some adverse reactions (e.g., fatigue, dizziness, somnolence, difficulty with memory, difficulty with concentration/attention) was dose-related and greater at higher than recommended topiramate dosing (200 mg/day) compared to the incidence of these adverse reactions at the recommended dosing (100 mg/day).

Table 6: Adverse Reactions in Pooled, Placebo-Controlled, Migraine Trials in Adults*,,

Topiramate Dosage
(mg/day)
Body System/
  Adverse Reaction
Placebo
(N=445)
%
50
(N=235)
%
100
(N=386)
%
Body as a Whole-General Disorders
Fatigue111415
Injury796
Central & Peripheral Nervous System Disorders
Paresthesia63551
Dizziness1089
Hypoaesthesia267
Language problems276
Gastro-Intestinal System Disorders
Nausea8913
Diarrhea4911
Abdominal pain566
Dyspepsia345
Dry mouth223
Gastroenteritis133
Metabolic and Nutritional Disorders
Weight loss169
Musculoskeletal System Disorders
Arthralgia273
Psychiatric Disorders
Anorexia6915
Somnolence587
Difficulty with memory277
Insomnia567
Difficulty with concentration/attention236
Mood problems236
Anxiety345
Depression434
Nervousness244
Confusion223
Psychomotor slowing132
Reproductive Disorders, Female
Menstrual disorder232
Reproductive Disorders, Male
Ejaculation premature030
Resistance Mechanism Disorders
Viral Infection344
Respiratory System Disorders
Upper respiratory tract infection121314
Sinusitis6106
Pharyngitis456
Coughing224
Bronchitis233
Dyspnea213
Skin and Appendages Disorders
Pruritis242
Special Sense Other, Disorders
Taste perversion1158
Urinary System Disorders
Urinary tract infection242
Vision Disorders
Blurred vision242
* Includes 35 adolescent patients age 12 to 15 years
Values represent the percentage of patients reporting a given reaction. Patients may have reported more than one adverse reaction during the study and can be included in more than one adverse reaction category.
Blurred vision was the most common term considered as vision abnormal. Blurred vision was an included term that accounted for more than 50% of reactions coded as vision abnormal, a preferred term

Of the 1135 patients exposed to immediate-release topiramate in the adult placebo-controlled studies, 25% discontinued due to adverse reactions, compared to 10% of the 445 placebo patients. The adverse reactions associated with discontinuing therapy in the immediate-release topiramate-treated patients in these studies included paresthesia (7%), fatigue (4%), nausea (4%), difficulty with concentration/attention (3%), insomnia (3%), anorexia (2%), and dizziness (2%).

Patients treated in these studies experienced mean percent reductions in body weight that were dose-dependent. This change was not seen in the placebo group. Mean changes of 0%, -2%, -3%, and -4% were seen for the placebo group, immediate-release topiramate 50 mg, 100 mg, and 200 mg groups, respectively.

Pediatric Patients 12 to 17 Years of Age

In five randomized, double-blind, placebo-controlled, parallel group clinical trials for the preventive treatment of migraine, most of the adverse reactions occurred more frequently during the titration period than during the maintenance period. Among adverse reactions with onset during titration, approximately half persisted into the maintenance period.

In four, fixed-dose, double-blind clinical trials for the preventive treatment of migraine in pediatric patients 12 to 17 years of age, the most common adverse reactions with immediate-release topiramate 100 mg that were seen at an incidence higher (≥5%) than in the placebo group were: paresthesia, upper respiratory tract infection, anorexia, and abdominal pain (see Table 7). Table 7 shows adverse reactions from the pediatric trial (Study 13 [see Clinical Studies]) in which 103 pediatric patients were treated with placebo or 50 mg or 100 mg of immediate-release topiramate, and three predominantly adult trials in which 49 pediatric patients (12 to 17 years of age) were treated with placebo or 50 mg, 100 mg or 200 mg of immediate-release topiramate [see Clinical Studies]. Table 7 also shows adverse reactions in pediatric patients in controlled migraine trials when the incidence in an immediate-release topiramate dose group was at least 5% or higher and greater than the incidence of placebo. Many adverse reactions shown in Table 7 indicate a dose-dependent relationship. The incidence of some adverse reactions (e.g., allergy, fatigue, headache, anorexia, insomnia, somnolence, and viral infection) was dose-related and greater at higher than recommended immediate-release topiramate dosing (200 mg daily) compared to the incidence of these adverse reactions at the recommended dosing (100 mg daily).

Table 7: Adverse Reactions in Pooled Double-Blind Studies for the Preventive Treatment of Migraine in Pediatric Patients 12 to 17 Years of Age)*

Body System/
Adverse Reaction
Immediate-Release Topiramate Dosage
Placebo
(N=45)
%
50 mg/day
(N=46)
%
100 mg/day
(N=48)
%
Body as a Whole – General Disorders
Fatigue778
Fever246
Central & Peripheral Nervous System Disorders
Paresthesia72019
Dizziness446
Gastrointestinal System Disorders
Abdominal pain9715
Nausea448
Metabolic and Nutritional Disorders
Weight loss274
Psychiatric Disorders
Anorexia4910
Somnolence226
Insomnia292
Resistance Mechanism Disorders
Infection viral448
Respiratory System Disorders
Upper respiratory tract infection112623
Rhinitis276
Sinusitis294
Coughing072
Special Senses Other, Disorders
Taste perversion226
Vision Disorders
Conjunctivitis474
* 35 adolescent patients aged 12 to <16 years were also included in adverse reaction assessment for adults
Incidence is based on the number of subjects experiencing at least 1 adverse event, not the number of events.

In the double-blind placebo-controlled studies, adverse reactions led to discontinuation of treatment in 8% of placebo patients compared with 6% of immediate-release topiramate-treated patients. Adverse reactions associated with discontinuing therapy that occurred in more than one immediate-release topiramate-treated patient were fatigue (1%), headache (1%), and somnolence (1%).

Increased Risk For Bleeding

Topiramate is associated with an increased risk for bleeding. In a pooled analysis of placebo-controlled studies of approved and unapproved indications, bleeding was more frequently reported as an adverse reaction for topiramate than for placebo (4.5% versus 3.0% in adult patients, and 4.4% versus 2.3% in pediatric patients). In this analysis, the incidence of serious bleeding events for topiramate and placebo was 0.3% versus 0.2% for adult patients, and 0.4% versus 0% for pediatric patients.

Adverse bleeding reactions reported with topiramate ranged from mild epistaxis, ecchymosis, and increased menstrual bleeding to life-threatening hemorrhages. In patients with serious bleeding events, conditions that increased the risk for bleeding were often present, or patients were often taking drugs that cause thrombocytopenia (other antiepileptic drugs) or affect platelet function or coagulation (e.g., aspirin, nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, or warfarin or other anticoagulants).

Other Adverse Reactions Observed During Clinical Trials

Other adverse reactions seen during clinical trials were: abnormal coordination, eosinophilia, gingival bleeding, hematuria, hypotension, myalgia, myopia, postural hypotension, scotoma, suicide attempt, syncope, and visual field defect.

Laboratory Test Abnormalities

Adult Patients

In addition to changes in serum bicarbonate (i.e., metabolic acidosis), sodium chloride, and ammonia, immediate-release topiramate was associated with changes in several clinical laboratory analytes in randomized, double-blind, placebo-controlled studies [see WARNINGS AND PRECAUTIONS]. Controlled trials of adjunctive topiramate treatment of adults for partial-onset seizures showed an increased incidence of markedly decreased serum phosphorus (6% topiramate versus 2% placebo), markedly increased serum alkaline phosphatase (3% topiramate versus 1% placebo), and decreased serum potassium (0.4% topiramate versus 0.1% placebo).

Pediatric Patients

In pediatric patients (1-24 months) receiving adjunctive topiramate for partial-onset seizures, there was an increased incidence for an increased result (relative to normal analyte reference range) associated with immediate-release topiramate (vs placebo) for the following clinical laboratory analytes: creatinine, BUN, alkaline phosphatase, and total protein. The incidence was also increased for a decreased result for bicarbonate (i.e., metabolic acidosis) and potassium with immediate-release topiramate (vs. placebo) [see Use In Specific Populations]. TROKENDI XR® is not indicated for partial-onset seizures in pediatric patients less than 6 years of age.

In pediatric patients (ranging from 6-17 years of age) receiving immediate-release topiramate for the preventive treatment of migraine, there was an increased incidence for an increased result (relative to normal analyte reference range) associated with immediate-release topiramate (vs placebo) for the following clinical laboratory analytes: creatinine, BUN, uric acid, chloride, ammonia, alkaline phosphatase, total protein, platelets, and eosinophils. The incidence was also increased for a decreased result for phosphorus, bicarbonate, total white blood count, and neutrophils [see Use In Specific Populations]. TROKENDI XR® is not indicated for the preventive treatment of migraine in pediatric patients less than 12 years of age.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of immediate-release topiramate. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body as a Whole-General Disorders: oligohydrosis and hyperthermia [see WARNINGS AND PRECAUTIONS], hyperammonemia, hyperammonemic encephalopathy [see WARNINGS AND PRECAUTIONS], hypothermia with concomitant valproic acid [see WARNINGS AND PRECAUTIONS].

Gastrointestinal System Disorders: hepatic failure (including fatalities), hepatitis, pancreatitis

Skin and Appendage Disorders: bullous skin reactions (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis) [see WARNINGS AND PRECAUTIONS], pemphigus

Urinary System Disorders: kidney stones, nephrocalcinosis [see WARNINGS AND PRECAUTIONS]

Vision disorders: acute myopia, secondary angle closure glaucoma [see WARNINGS AND PRECAUTIONS], maculopathy

Hematological Disorders: decrease of the International Normalized Ratio (INR) or prothrombin time when given concomitantly with vitamin K antagonist anticoagulant medications such as warfarin.

Read the entire FDA prescribing information for Trokendi XR (Topiramate Extended-release Capsules)

SLIDESHOW

What Is Epilepsy? Symptoms, Causes, and Treatments See Slideshow

© Trokendi XR Patient Information is supplied by Cerner Multum, Inc. and Trokendi XR Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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