Dosing & Conversion

All commercially insured patients new to Trokendi XR pay nothing for a minimum of 12 prescriptions*—guaranteed.

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Trokendi XR® (topiramate) delivers once-daily treatment that offers seamless conversion from Topamax® (topiramate)1

Once-daily Trokendi XR (topiramate) and twice-daily Topamax (topiramate)—bioequivalent at all doses1, 2
Conversion chart for Trokendi XR® (topiramate)

Dose and titration rate should be guided by clinical outcome. If required, longer intervals between dose adjustments can be used.

Trokendi XR (topiramate) 100 mg/day—SWITCH for the full potential of topiramate1

  1. Identify immediate-release topiramate patients and convert to Trokendi XR
  2. Titrate to total daily dose of 100 mg, where appropriate

Trokendi XR (topiramate) dosing considerations3

Administration with alcohol
Alcohol use should be completely avoided within 6 hours prior to and 6 hours after Trokendi XR administration.

Dose modifications in patients with renal impairment
In patients with renal impairment (creatinine clearance less than 70 mL/min/1.73 m2), one-half of the usual adult dose is recommended. Such patients will require a longer time to reach steady-state at each dose. Prior to dosing, obtain an estimated GFR measurement in patients at high risk for renal insufficiency (eg, older patients or those with diabetes mellitus, hypertension, or autoimmune disease).

Dosage modifications in patients undergoing hemodialysis
Topiramate is cleared by hemodialysis at a rate that is 4 to 6 times greater than in patients with normal renal function. Accordingly, a prolonged period of dialysis may cause topiramate concentration to fall below that required to maintain an antiseizure effect. To avoid rapid drops in topiramate plasma concentration during hemodialysis, a supplemental dose of topiramate may be required. The actual adjustment should take into account the:

  • Duration of the dialysis period
  • Clearance rate of the dialysis system being used
  • Effective renal clearance of topiramate in the patient being dialyzed

Laboratory testing prior to treatment initiation
Measurement of baseline and periodic serum bicarbonate during Trokendi XR treatment is recommended.

Dosing modifications in patients taking phenytoin and/or carbamazepine
The coadministration of Trokendi XR with phenytoin may require an adjustment of the dose of phenytoin to achieve optimal clinical outcome. Addition or withdrawal of phenytoin and/or carbamazepine during adjunctive therapy with Trokendi XR may require adjustment of the dose of Trokendi XR.

Monitoring for therapeutic blood levels
It is not necessary to monitor topiramate plasma concentrations to optimize Trokendi XR therapy.

Administration instructions
Trokendi XR may be taken without regard to meals. Swallow capsule whole and intact. Do not sprinkle on food, chew, or crush.

Contraindications
Trokendi XR is contraindicated in patients with recent alcohol use (within 6 hours prior to and 6 hours after Trokendi XR use).

Abbreviation: GFR, glomerular filtration rate.

Learn how your eligible patients can pay $0 per prescription for Trokendi XR (topiramate)*

All commercially insured patients new to Trokendi XR pay nothing for a minimum of 12 prescriptions*—guaranteed.

Zero dollar co-pay icon
Trokendi XR® (topiramate) co-pay card

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

WARNINGS & PRECAUTIONS

DOSING GUIDELINES & CONSIDERATIONS

ADVERSE REACTIONS

 

INDICATION

Please refer to the full Prescribing Information and Medication Guide for additional important information on Trokendi XR.

Trokendi XR (topiramate) extended-release capsules

 

REFERENCES:

  1. Data on file. Supernus Pharmaceuticals, Inc., Rockville, MD.
  2. Topamax [package insert]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; June 2018.
  3. Trokendi XR [package insert]. Rockville, MD: Supernus Pharmaceuticals, Inc.; January 2018.