Trokendi XR (topiramate) can cause mild to serious side effects. More common side effects include weight loss and fatigue. If side effects from Trokendi XR become difficult to tolerate, talk with your doctor about coping tips or other treatment options.

Trokendi XR is a prescription medication used to:

  • help prevent migraine headaches in adults and some children
  • treat epilepsy in adults and some children who experience:

Depending on your condition, Trokendi XR may be prescribed alone or with other drugs.

Keep reading to learn about the common, mild, and serious side effects Trokendi XR can cause.

Below are just a few of the more common side effects reported by people who took Trokendi XR in studies. These side effects can vary depending on what condition the drug is being used to treat.

More common side effects in people taking Trokendi XR for epilepsy include:

More common side effects in people taking Trokendi XR for migraine headaches include:

Keep reading to learn about other possible mild and serious side effects of Trokendi XR.

Like most drugs, Trokendi XR can cause mild side effects. Some of these may be more common than others. But in general, many people who take Trokendi XR don’t experience side effects.

Examples of mild side effects that have been reported with Trokendi XR include:

  • abdominal pain
  • nausea
  • diarrhea
  • dizziness
  • tingling in the arms and legs
  • nervousness
  • sleepiness or drowsiness
  • fatigue
  • memory problems
  • slowed reaction times
  • speech problems
  • changes in how food or drink tastes
  • decreased appetite
  • hair loss (see the “Side effects explained” section for details)
  • weight loss (see the “Side effects explained” section for details)

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. Do not stop using Trokendi XR unless your doctor recommends it.

Trokendi XR may cause mild side effects other than the ones listed above. See the Trokendi XR prescribing information for details.

Serious side effects that have been reported with Trokendi XR include:

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.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Trokendi XR and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

Like most drugs, Trokendi XR can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage your symptoms, they may suggest an over-the-counter antihistamine you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a product you apply to your skin, such as hydrocortisone cream.

If your doctor confirms you had a mild allergic reaction to Trokendi XR, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Trokendi XR, they may have you switch to a different treatment.

Keep reading for answers to some frequently asked questions about Trokendi XR’s side effects.

How do the side effects of Trokendi XR compare with topiramate and Topamax?

Trokendi XR, topiramate, and Topamax are medications commonly used to treat epilepsy and help prevent migraine headaches. They share common side effects because they contain the same active ingredient, topiramate. Common side effects include tingling in the arms and legs, weight loss, and decreased appetite.

Topiramate is available in the following generic forms: oral tablet, oral capsule, and extended-release oral capsule. (With extended release, the drug is released slowly in your body over time.) Trokendi XR is the brand-name version of topiramate extended-release capsule, while Topamax is the brand-name version of topiramate oral tablet and oral capsule.

Since topiramate and Trokendi XR are extended-release medications, there may be a lower risk of certain side effects compared with Topamax or topiramate oral tablet or capsule, which are immediate-release medications. (With immediate release, the drug is released right away when you take it.)

If you have questions about how the side effects of Trokendi XR compare with topiramate or Topamax, talk with your doctor or pharmacist.

Are there side effects from stopping Trokendi XR?

Yes, certain side effects can occur if you suddenly stop taking Trokendi XR. This includes seizures in people who don’t have a history of seizures or epilepsy. It also includes having seizures more often or having seizures that do not stop in people with epilepsy.

If you and your doctor decide to stop Trokendi XR, your doctor will slowly lower your dosage over time. This is to help lower the risk of having seizures. If your treatment needs to be stopped quickly, your doctor will monitor you appropriately.

Talk with your doctor before you stop taking Trokendi XR. If you have questions about stopping treatment, they can discuss the best way to do so for your specific condition.

Can Trokendi cause long-term side effects?

Yes, taking Trokendi may cause long-term side effects in rare cases. These include:

  • vision problems
  • suicidal thoughts and behaviors
  • metabolic acidosis

These side effects could start at any time while you’re taking Trokendi XR. But they aren’t expected to start after treatment ends.

If you’re interested in learning more about Trokendi XR and its long-term side effects, talk with your doctor or pharmacist.

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

Hair loss

Although not common, hair loss is a side effect you may have from taking Trokendi XR.

In studies, this side effect was reported only in people taking Trokendi XR for epilepsy. No one taking the drug to prevent migraine headaches reported hair loss as a side effect.

What might help

If you have hair loss while taking Trokendi XR, talk with your doctor. They may suggest a treatment for this side effect or tips for preventing it. Or they may recommend you stop taking Trokendi XR and try a different medication for your condition.

Other drugs used to treat epilepsy, including valproic acid and carbamazepine (Tegretol, Carbatrol), can also cause hair loss. So when discussing hair loss with your doctor, be sure they’re aware of all medications you may be taking to treat epilepsy.

Weight loss

You may have weight loss as a side effect of taking Trokendi XR. This was among the more common side effects reported in studies of the drug, regardless of the condition it was being used for.

Trokendi XR can also cause decreased appetite as a side effect. This may make you feel less hungry and lead to weight loss.

What might help

Talk with your doctor if you’re concerned about your weight while taking Trokendi XR. They may suggest ways to treat this side effect. But if the weight loss is troubling or doesn’t resolve, your doctor may suggest a treatment other than Trokendi XR for your condition.

Vision problems

Trokendi XR can cause vision problems. While these were rare in studies of the drug, vision problems can be severe. If left untreated, vision problems caused by Trokendi XR can cause permanent vision loss.

Vision problems reported by people taking Trokendi XR in studies include:

These side effects are most likely to occur during your first month of taking Trokendi XR.

What might help

If you notice symptoms of vision problems while taking Trokendi XR, contact your doctor right away. They’ll likely recommend you stop taking the drug and suggest other treatments for your condition.

Decreased sweating

Taking Trokendi XR can cause decreased sweating as a side effect, though this is not common. Decreased sweating can cause an increase in your body temperature. In extreme cases, this rise in body temperature may require treatment in the hospital.

Most cases of decreased sweating caused by Trokendi XR have been in children taking the drug. Some cases were reported after people spent significant time outside in hot weather.

Symptoms can include:

  • chills
  • fever
  • not sweating in hot temperatures

What might help

While taking Trokendi XR, pay close attention for any of the symptoms listed just above. Also, try to avoid spending lots of time in hot weather or hot environments.

If you develop a severe fever or one that doesn’t go away, or you notice decreased sweating while taking Trokendi XR, contact your doctor right away. They’ll likely recommend you stop taking the drug and suggest other treatments for your condition.

Before taking Trokendi XR, discuss your health history with your doctor. Trokendi XR may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Disclaimer: Healthline 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.