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Topamax in Tails and a Top-Hat? New Long-Acting Trokendi XR Hits the Shelves

by Dr. Sharon Orrange on September 24, 2013 at 10:43 am

Topamax (topiramate) is used for the treatment of epilepsy, migraine headaches and weight loss (as half of the new weight loss drug Qsymia). Now, there is a new long-acting Topamax called Trokendi XR.

What’s the scoop with this new Topamax that’s hitting the shelves and is it any better than topiramate?

  •  Trokendi XR is now available to patients in the United States. Trokendi XR is a once-daily extended release formulation of topiramate (Topamax) used for the treatment of epilepsy.

  •  Trokendi XR has been approved, for now, only as an anti-epileptic drug indicated for treatment in patients 10 years of age and older with partial onset or primary generalized tonic-clonic seizures.

  •  It’s available in 25mg, 50mg, 100mg, and 200mg extended-release capsules.

  •  We don’t know or think it’s any better than Topamax but it may have easier once daily dosing.

  •  When Trokendi XR is widely available it will be pricier than Topamax.

  •  Topamax (topiramate) is available as a cheaper generic so you and your doctor will decide if its worth the cost to switch.

Dr O.

Trokendi XR will start from around $180 for 30 capsules of the lowest dose, 25 mg, up to about $650 for 30 capsules of the highest 200 mg dose. Since there is a generic version of topiramate available, many insurance plans will consider Trokendi XR a Tier 2 or 3 medication if it’s covered, meaning you’ll pay a higher co-pay. In contrast, generic topiramate is available from many pharmacies at under or around $20 for 60 tablets, depending on the strength, and will be covered by most insurance plans under the lowest tier or co-pay level.


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