Unlabeled Use:
Absorption: Well absorbed (80%) after oral administration.
Distribution: Unknown.
Metabolism/Excretion: 70% excreted unchanged in urine.
Half-life: 21 hr; Extended-release 31 hr.
Contraindicated in:
Use Cautiously in:
Derm: STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, oligohydrosis (↑ in children).
EENT: abnormal vision, diplopia, nystagmus, acute myopia/secondary angle closure glaucoma, ↑ intraocular pressure, mydriasis, ocular pain, ocular redness, retinal detachment, visual field defects.
F and E: hyperchloremic metabolic acidosis.
GI: nausea, abdominal pain, anorexia, constipation, dry mouth, encephalopathy, hyperammonemia.
GU: kidney stones.
Hemat: BLEEDING, leukopenia.
Metab: weight loss, hyperthermia (↑ in children).
Neuro: ataxia, paresthesia, tremor , SEIZURES, SUICIDAL THOUGHTS, cognitive disorders, dizziness, drowsiness, fatigue, impaired concentration/memory, nervousness, psychomotor slowing, speech problems, sedation, aggressive reaction, agitation, anxiety, confusion, depression, malaise, mood problems.
Misc: fever.
Drug-Drug:
Epilepsy (monotherapy)
10 yr): Immediate-release 25 mg twice daily initially, gradually ↑ at weekly intervals to 200 mg twice daily over a 6wk period; Extended-release (Qudexy XR or Trokendi XR) 50 mg once daily initially, gradually ↑ at weekly intervals to 400 mg once daily over a 6wk period.
11 kg): Immediate-release 25 mg once daily in the evening initially, gradually ↑ at weekly intervals to 75 mg twice daily over a 57-wk period; if needed may continue to titrate dose on a weekly basis up to 125 mg twice daily; Extended-release (Qudexy XR or Trokendi XR) 25 mg once daily for 1 wk, then ↑ to 50 mg once daily for 1 wk, then ↑ by 2550 mg/day at weekly intervals over a 57-wk period to target dose of 150250 mg once daily.Renal Impairment
Epilepsy (adjunctive therapy)
17 yr): Immediate-release 2550 mg/day initially, ↑ by 2550 mg/day at weekly intervals up to 200400 mg/day in 2 divided doses (200400 mg/day in 2 divided doses for partial seizures or Lennox-Gastaut syndrome and 400 mg/day in 2 divided doses for primary generalized tonic-clonic seizures); Extended-release (Qudexy XR or Trokendi XR) 2550 mg once daily initially, ↑ by 2550 mg/day at weekly intervals up to 200400 mg once daily (for partial seizures or Lennox-Gastaut syndrome) and 400 mg once daily (for primary generalized tonic-clonic seizures).Renal Impairment
Migraine Prevention
12 yr): Immediate-release 25 mg at night initially, ↑ by 25 mg/day at weekly intervals up to target dose of 100 mg/day in 2 divided doses; Extended-release (Qudexy XR) 25 mg once daily initially, ↑ by 25 mg/day at weekly intervals up to target dose of 100 mg once daily.Renal Impairment
(Generic available)
NDC Code*