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Emgality vs. Trokendi XR

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Emgality (galcanezumab) and topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) are both used to prevent migraines, but they work in different ways and have different uses. Emgality is a monoclonal antibody that blocks a protein called calcitonin-gene related peptide (CGRP) to prevent migraines and treat cluster headaches. It is given as a monthly injection under the skin. On the other hand, topiramate is an antiepileptic medication that can prevent migraines and treat various types of seizures. It is taken orally, either once or twice daily, and is available in both immediate-release and extended-release forms, as well as a liquid. Emgality is only available as a brand-name medication, while topiramate is available in generic forms, making it potentially more affordable. Emgality's common side effects include injection site reactions, while Topiramate can cause side effects like drowsiness, weight loss, and trouble thinking clearly. Additionally, topiramate has more serious risks, such as vision problems and high blood acid levels, and it can interact with many other medications.

Emgality

(galcanezumab)

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Trokendi XR

(topiramate)

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Summary for Emgality

Prescription only

Emgality (galcanezumab or galcanezumab-gnlm) is an injectable medication that can help prevent migraine attacks in adults. It can also help treat cluster headaches in adults. This medication is a monoclonal antibody that works as a CGRP antagonist. It blocks the CGRP protein in the brain that can cause migraine and headache pain. Emgality (galcanezumab) comes as a prefilled pen and syringe. You inject one dose of the medication under the skin monthly. Some common side effects include pain, itching, and redness at the injection site.

Indications for Emgality

Pros and Cons for Emgality

Pros

  • Only needs to be given once a month
  • Good option for people who have a hard time taking medications by mouth
  • Generally well tolerated

Cons

  • Not a good option for people who don't like needles
  • Need to store in a refrigerator
  • Not known if the medication works well or is safe in children, during pregnancy, or while breastfeeding

Common Side Effects for Emgality

  • Pain, itching, warmth, and other injection site reactions (18%)

Warnings for Emgality

  • Serious allergic reactions
  • High blood pressure
  • Raynaud's phenomenon

Summary for Trokendi XR

Prescription only

Trokendi XR, the brand name for topiramate extended-release capsules, is an antiepileptic medication. It's used alone or together with other medications to treat some types of seizures in people 6 years and older. It can also help prevent migraines in people 12 years and older. You take the dosage by mouth once a day. This medication can cause side effects like dizziness and tingling of the arms and legs. It can also have interactions with other medications. Trokendi XR (topiramate) is available as brand-name and generic versions.

Indications for Trokendi XR

Pros and Cons for Trokendi XR

Pros

  • Only taken once a day
  • Can take by itself or with other medications to control seizures
  • Can also help prevent migraines
  • Approved for both adults and children (age depends on the health problem)

Cons

  • Must swallow whole, so not a good option if you have trouble swallowing pills
  • Can cause sleepiness and tingling in the arms or legs
  • Risk of serious eye problems and kidney stones
  • Interacts with alcohol and many medications, like birth control pills, warfarin, and divalproex (Depakote)

Common Side Effects for Trokendi XR

  • Tingling in arms and legs
  • Sleepiness
  • Dizziness
  • Fatigue
  • Low appetite
  • Weight loss
  • Nervousness
  • Depression
  • Trouble concentrating
  • Trouble remembering things
  • Trouble sleeping
  • Trouble moving or keeping balance
  • Fever
  • Mood changes
  • Change in taste

Warnings for Trokendi XR

  • Vision problems
  • High body temperature and trouble sweating
  • Too much acid in the blood (metabolic acidosis)
  • Changes in mood and risk of suicidal thoughts or behavior
  • Problems with memory, speech, or coordination
  • Sleepiness, tiredness, and lower concentration
  • High ammonia levels in the blood
  • Serious skin reactions
  • Kidney stones
  • Risk of seizures if you stop the medication suddenly
  • Bone or growth problems in children
  • Interaction with other medications
  • Harm to an unborn baby

Prices with our coupons for Emgality vs. Trokendi XR

Price Card Drug Icon
Emgality1 pen / 120mg/ml
$630.16$881.66
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Price Card Drug Icon
Topiramate ER (Trokendi XR)30 capsules / 25mg of
$99.98$258.48
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