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Does Trokendi XR cause hair loss?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 5, 2023.

Official answer


Yes, topiramate, the active ingredient in Trokendi XR has been shown to cause hair loss (alopecia) in clinical studies, but it is not a common side effect. Alopecia with immediate-release topiramate has been reported in 1% to 4% of children ages 6 to 16 years of age, and in 3% to 4% of patients older than 16 years of age. Higher doses of topiramate (400 mg/day) led to higher rates of hair loss than lower doses (50 mg/day).

Data evaluating side effects with Trokendi XR were gathered from previous studies evaluating immediate-release topiramate. It is expected that Trokendi XR would produce a similar side effect profile as immediate-release topiramate, as reported by the manufacturer in the product label.

What is Trokendi XR approved for?

Trokendi XR is an extended-release (long-acting) oral capsule that is taken once-a-day to help prevent seizures in certain forms of epilepsy in patients 6 years of age and older and for migraine prevention in patients 12 years and older.

For seizure prevention in patients 6 years and older, Trokendi XR is used as initial monotherapy (as the only medicine) for the treatment of partial onset or primary generalized tonic-clonic seizures. It is also used with other medicines for the treatment of partial-onset, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome (LGS) in patients 6 years of age and older.

Which side effects occur most commonly?

Trokendi XR can have a number of common side effects when used for either epilepsy or migraine headache prevention. Some of the more common side effects include:

In epilepsy: (incidence ≥ 10% and more frequent than placebo or low-dose topiramate)

  • paresthesia (unusual feeling of the skin, such as burning, numbness, tingling, or “pin-and-needles”)
  • anorexia (lack or loss of appetite)
  • weight loss
  • speech disorders or related speech problem
  • fatigue and somnolence (drowsiness)
  • dizziness
  • nervousness
  • mental slowing, slowed reflexes
  • vision change
  • fever

In migraine: (incidence ≥5% and more frequent than placebo):

  • paresthesia
  • anorexia
  • weight loss
  • difficulty with memory
  • altered taste
  • diarrhea
  • hypoesthesia (a decrease in sensations such as the feeling of touch or temperature)
  • nausea
  • pain in stomach area
  • upper respiratory tract infection

Trokendi XR also has a number of more serious warnings, precautions and side effects.

Who makes Trokendi XR?

Trokendi XR is made by Supernus Pharmaceuticals. Immediate-release topiramate is available as a generic option, but Trokendi XR is not yet available generically. Immediate-release generic topiramate is manufactured by several different companies.

Trokendi XR comes as extended-release capsules in strengths of 25 mg, 50 mg, 100 mg, and 200 mg.

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


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