Key Points

• Topamax and Trokendi XR are both used to help prevent seizures in certain forms of epilepsy and to prevent migraine headaches, but there are some major differences between these two drugs, too.
• Both drugs contain the same active ingredient called topiramate. Trokendi XR comes as an extended-release (long-acting) oral capsule and Topamax come as an immediate-release tablet or capsule.
• Trokendi XR is taken once a day, while Topamax is usually taken twice a day, in the morning and evening. At the beginning of treatment, your Topamax dose may only be taken once a day at night for a short period of time.
• There are differences in the age groups that these medicines are approved to treat, as well as doses and costs. Only use the medication that your doctor prescribed for you.

Learn more: Comparing Topamax vs Trokendi XR

Are Topamax and Trokendi XR used to treat the same conditions?

Both Topamax and Trokendi XR are approved by the FDA for the same medical conditions: seizure control in certain forms of epilepsy and for migraine headache prevention.

Some differences in their use:

• Topamax is used alone (monotherapy) as initial treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older. Trokendi XR is also used as monotherapy for these seizure types, but in patients 6 years of age and older.
• Topamax and Trokendi XR are both approved to be used with other medicines (adjunctive) for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome. For these uses, Topamax is approved in patients 2 years of age and older, and Trokendi XR is approved for use in patients 6 years of age and older.
• Both Topamax and Trokendi XR are approved for the preventive treatment (prophylaxis) of migraine headache in patients 12 years of age and older. Topiramate will not stop a migraine once it has started.

Topiramate, the active drug in Topamax and Trokendi XR is classified as an anticonvulsant (seizure) medication, but is prescribed for other conditions such as migraine. It is also frequently prescribed "off-label" for other uses such as alcohol dependence, but this use if not approved by the FDA.

There are other differences between Topamax and Trokendi XR; this is not a complete list. Check with your doctor if you have questions about the use of either drug.

Which costs more - Topamax or Trokendi XR?

Topamax and Trokendi XR are both brand name drugs for topiramate. Topamax is made by Janssen Pharmaceuticals and Trokendi XR is made by Supernus Pharmaceuticals. Generic topiramate is manufactured by several different companies.

Topamax and Trokendi XR are both approved by the FDA as a generic option in the U.S., but Trokendi XR will not be available in pharmacies until 2023 due to patent law.

Generic immediate-release topiramate it is very affordable and would typically be covered by insurance plans, as well as by Medicaid and Medicare. Check with your insurance plan to see if brand name products are covered, but the generic option may be preferred and lower in cost in most cases, when available.

Prices: Topamax, Trokendi XR and topiramate

• The cash price cost for brand name Topamax oral tablet 25 mg is around $400 for a supply of 60 tablets.
• The cash price for brand name Trokendi XR 25 mg is around $333 for a supply of 30 capsules.
• The cash price for topiramate oral tablet 25 mg (the generic for Topamax) is around $10 for a supply of 60 tablets.This price may range up to $60 or more, so you should check prices at several pharmacies.
• The generic for Trokendi XR is not yet available in the U.S.

These prices are based on using the Drugs.com discount card which is accepted at most U.S.-based pharmacies. Prices are for cash paying customers only and are not valid with insurance plans. Your prices may vary, depending on the pharmacy you visit and where you live.

If you are having trouble affording your medications, the manufacturer of Topamax or Trokendi XR may be able to offer you a copay card to lower your out-of-pockets costs or prescription patient assistance, based on your insurance type or financial information. Contact the manufacturers for more information.

This is not all the information you need to know about Topamax, Trokendi XR or topiramate for safe and effective use. Review the full patient information and discuss this and any questions you have with your doctor or other health care provider.