How Much Is Topiramate Without Insurance?

Topiramate (Topamax) is a prescription-only medication used to treat certain types of seizures in people with epilepsy (seizure disorder). The types of seizures topiramate can treat are: primary generalized tonic-clonic, partial onset, and Lennox-Gastaut syndrome seizures. The medication is also FDA approved to help prevent migraines. 

Epileptic seizures occur when nerve cells in the brain send the wrong signals to the body at too fast a pace, potentially causing involuntary movement. To prevent seizures, topiramate stops the brain from sending these disorganized signals to the body.

Topiramate basics

The chart below provides a snapshot of information about topiramate.

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Topiramate Basics

Is topiramate covered by insurance?

Health insurance plans typically cover epilepsy and migraine treatments, including many medications. For example, all Medicare Part D plans cover generic topiramate. But they may not cover brand-name forms like Topamax.

If you have insurance, check your plan’s summary of benefits and coverage and formulary to determine whether generic topiramate or the brand-name options are covered.

How insurance covers topiramate

Most health insurance plans that cover generic topiramate don’t require a prior authorization or step therapy. However, a prior authorization is required for about 1 in 14 people with Medicare.

The following chart shows the likelihood of having coverage for topiramate, as well as needing a prior authorization or to do step therapy, with commercial insurance, Affordable Care Act (ACA), Medicare, and Medicaid plans.

Insurance Coverage for Generic Topiramate

Source: Managed Markets Insight & Technology, LLC™, as of September 26, 2024. (See methodology below.)

Tips if your medication isn’t covered by insurance

Here are a few options if your insurance does not cover generic topiramate or brand-name forms such as Topamax:

• Talk to your prescriber about alternative medications.

• Request a formulary exception from your insurer. If the request is denied, consider filing an appeal for coverage.

• Try enrolling in a patient assistance program.

• Use a GoodRx coupon for potential savings.

• Consider changing your prescription medication coverage during your next open enrollment period.

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• How it works: Topiramate (Topamax) works by blocking your brain from sending certain electrical or chemical signals that could trigger a seizure.

• Side effects: The most common side effects for topiramate include dizziness, pins and needles sensation, nervousness, and nausea. 

• Topiramate interactions: Topiramate interacts with other medications in a variety of ways. For instance, it can make oral birth control less effective.

How much does topiramate cost without insurance?

If you don’t have health insurance, the price of generic topiramate or brand-name Topamax may depend on the following factors: 

• Your prescribed dosage

• Your dosage form (tablet, capsule, or solution)

• Whether you’re getting a brand-name or generic version

• The fill amount (90-day supply versus 30-day supply)

• Your geographic location

• The specific pharmacy you use

The charts below contain recent average retail prices for 30-day supplies of generic topiramate.

Brand-name topiramate

As mentioned, topiramate is available in several brand-name versions. Generic medications typically cost less than their brand-name counterparts. However, topiramate oral liquid is only available as brand-name Eprontia.

The charts below contain recent average retail prices for 30-day supplies of the brand-name versions of topiramate: Topamax, Qudexy XR, and Eprontia.

Ways to save on brand-name topiramate

You may be able to save money on brand-name topiramate if you qualify for patient assistance programs. Here’s a summary of the programs and savings options available for each version:

• Topamax: If you have private or commercial insurance, you may qualify for a coupon for Topamax through the Topamax Savings Program. With this program, you could pay $4 per prescription fill, if you use a pharmacy that participates and accepts the coupon. The coupon could save you up to $1,800 on 12 prescription fills per calendar year. The program is not available to people with Medicare, Medicaid, or other government-funded health insurance plans.

• Qudexy XR: The manufacturer of Qudexy XR makes an authorized generic, which costs less than the brand-name version.

• Eprontia: You may be able to get Eprontia for $0 if you have commercial or private insurance. If you have government-sponsored insurance — such as Medicare, Medicaid, or Tricare — the maker of Eprontia offers a bridge program that covers the cost of the medication if insurance approval takes more than 48 hours. You may still qualify for assistance if you don’t have insurance. You can find more information on copay assistance and other types of financial aid on the Azurity Solutions page for Eprontia.

How to afford topiramate without insurance

Here are five ways to save on generic topiramate without insurance.

1. Use a GoodRx coupon

With a GoodRx coupon, you may be able to pay a lower price for your prescription.

Here’s how to get a coupon:

• Visit www.goodrx.com or install the GoodRx app on your mobile device.

• Type “Topiramate” in the search field. Be sure to select “Topiramate (generic Qudexy XR)” or “Topiramate (generic Topamax)” in the drop-down menu.

• Select the correct dose and quantity, and set your location.

• Choose whether you want to receive your coupon via text or email, print it out, or save it on the GoodRx app. 

• Show the coupon at the pharmacy when you pick up your medication. Or present the coupon to your pharmacy’s staff early in the filling process, such as when you first receive your prescription, to help prevent delays at the pick-up counter.

2. Request a 90-day supply

Ask your healthcare professional to write you a prescription for a 90-day supply of topiramate instead of a 30-day supply to compare costs. A 3-month supply may be a better value and reduce your trips to the pharmacy. If you have insurance that covers topiramate, ask about discounts for using your plan’s mail-order pharmacy.

3. Compare prices at various pharmacies

GoodRx can easily compare costs at different pharmacies to help you find the best topiramate price in your area.

4. Talk to your prescriber about alternatives

If you are concerned about the cost of your medication, tell your prescriber. There may be another medication or another version of your medication that better fits your budget, while still adequately treating your condition.

5. Use your tax-advantaged healthcare expense funds

If you have a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA), using those funds to purchase your medication can reduce your out-of-pocket costs through tax savings.

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Written by:

Brookie Madison

Brookie Madison is a freelance writer, communications professional, and content creator. She has more than eight years of experience covering topics including consumer health, personal finance, mental health, community outreach, education, and more.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

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Methodology

National prescription coverage data for each medication was obtained from Managed Markets Insight & Technology (MMIT), reflecting health insurance coverage as of September 2024. The percentage of enrollees in plans that cover each medication was calculated by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel. Similarly, the percentage of enrollees in plans with prior authorization was determined by calculating the proportion of enrollees in plans that require prior authorization for the medication within each channel. The percentage of enrollees in plans with step therapy was calculated as the proportion of enrollees in plans that impose step therapy requirements for the medication in each channel. These estimates, derived from national MMIT coverage data, provide insight into the health insurance coverage landscape for each medication, taking into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total population of enrollees covered by insurance across various channels, including ACA, commercial (excluding ACA) plans, Medicare, and Medicaid (both state and managed Medicaid).