Qudexy XR (Topiramate) for Migraine

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Qudexy XR (topiramate) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to help prevent migraine in people 12 years and older.

What Members Say

MHT logo These insights are based on 108 comments about Qudexy XR from MyMigraineTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Migraine frequency often drops with regular use.
Daily prevention can reduce the need for rescue medicines.
Staying on an effective dose can help keep migraine attacks from flaring back up.

Considerations:

Memory problems, word-finding trouble, and mental fog can interfere with daily tasks.
Fatigue, dizziness, and sleepiness can make focus and alertness harder.
Kidney stones and weight loss are important risks to discuss and monitor.

How Qudexy XR Works and How It’s Taken

Qudexy XR is an anti-seizure medication used to help prevent migraine. The exact way it works is not fully known. Studies suggest it affects sodium channels, GABA and glutamate receptors, and carbonic anhydrase enzymes in the brain, which may play a role in migraine prevention.

Doctors prescribe Qudexy XR when people 12 years and older need preventive treatment for migraine headaches.

Qudexy XR comes as an extended-release capsule taken by mouth once daily. The capsule can be swallowed whole or opened and sprinkled on a small spoonful of soft food.

The mixture should be swallowed right away without chewing. Do not store it for later use.

Typical Dosing for Migraine

The recommended starting dose of Qudexy XR for migraine prevention is 25 milligrams once daily during week 1. Doctors usually increase the dose over four weeks:

Week 1 — 25 milligrams once daily
Week 2 — 50 milligrams once daily
Week 3 — 75 milligrams once daily
Week 4 — 100 milligrams once daily

The recommended maintenance dose for migraine prevention is 100 milligrams once daily. In people with kidney problems, doctors may recommend one-half of the usual adult dose.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Qudexy XR

MHT logo These insights are based on 108 comments about Qudexy XR from MyMigraineTeam members.

Members who use Qudexy XR often say it helps to pay close attention to side effects, keep a steady routine, and stay in touch with a neurologist or other doctor if anything changes. Many members also mention that benefits and side effects can vary considerably from person to person, so practical day-to-day tracking matters.

1

Watch for side effects that affect memory, focus, or mood.
“I used to take topiramate and stopped due to the kind of work I do. It was making me foggy.”
2

Talk to your doctor if side effects and migraine control start to change.
“I’ve tried to reduce topiramate in half as advised by ENT due to side effects, but migraines are coming back.”
3

Tell your doctor about unusual physical side effects.
“But when the dose gets too high, I lose lots of weight and develop kidney stones and have to taper the dose off again.”

Connect with others who understand life with migraine. Join MyMigraineTeam for free.

Qudexy XR Side Effects

In clinical trials of Qudexy XR for the preventive treatment of migraine in people ages 12 years and older, the most common side effects occurred in about 5 percent to 51 percent of people. These include:

Paresthesia (tingling in the arms or legs)
Anorexia (loss of appetite)
Weight loss
Trouble with memory
Taste perversion (change in the way foods taste)
Diarrhea
Hypoesthesia (decreased feeling or sensitivity in the skin)
Nausea
Stomach or belly pain
Upper respiratory tract infection, such as a cold

Serious Side Effects and Warnings

Qudexy XR can cause serious side effects that may require immediate medical attention. These include:

Acute myopia and secondary angle-closure glaucoma — Serious eye problems, including sudden vision changes or eye pain, can lead to permanent vision loss.
Visual field defects — Changes in side vision may be reversible after stopping the medicine.
Oligohidrosis and hyperthermia — Decreased sweating and increased body temperature can lead to overheating, especially in hot weather.
Metabolic acidosis — Too much acid in the blood can affect bones, kidneys, growth in children, and pregnancy.
Suicidal thoughts or behavior — New or worsening depression, mood changes, or thoughts of self-harm can occur.
Cognitive and neuropsychiatric adverse reactions — Mental health side effects can include confusion, slowed thinking, trouble concentrating, speech or language problems, sleepiness, fatigue, depression, or mood problems.
Fetal toxicity during pregnancy — Qudexy XR may increase the risk of birth defects, such as cleft lip or cleft palate, and babies being small for gestational age.
Decrease in bone mineral density (BMD) — Bone density can decrease.
Negative effects on growth — Decreased height and weight growth can occur in children.
DRESS or multiorgan hypersensitivity — A severe drug reaction can include fever and organ problems.
Serious skin reactions — Stevens-Johnson syndrome and toxic epidermal necrolysis can cause a rash with blistering or peeling skin.
Severe allergic reactions — Anaphylaxis or angioedema can cause swelling of the face, lips, tongue, or throat, and trouble breathing.
Hyperammonemia and encephalopathy — High ammonia levels can cause unusual sleepiness, vomiting, or changes in thinking.
Kidney stones and nephrocalcinosis — Kidney stones or calcium buildup in the kidneys can occur.
Hypothermia when used with valproic acid — Dangerously low body temperature can affect thinking.

Get medical help right away if you think you are having a serious reaction.

How To Save on Qudexy XR

Upsher-Smith Laboratories, the manufacturer of Qudexy XR, offers the Access Pathways program. Eligible people with commercial insurance may pay as little as $0.

The Access Pathways program also offers benefits verification, prior authorization support, and a cash-pay option. Enrollment is available by phone only. To learn more, visit the Qudexy XR website.

What To Know Before Taking Qudexy XR

Before starting Qudexy XR, your doctor may order blood tests, including serum bicarbonate levels, because Qudexy XR can cause metabolic acidosis.

Tell your doctor if you have any allergies to topiramate or any ingredients in Qudexy XR. Do not take Qudexy XR if you have had a serious allergic reaction to topiramate, Qudexy XR, or any of its ingredients.

Tell your doctor about all medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.

Especially tell your doctor if you take:

Valproic acid medicines, such as Depakene or Depakote
Alcohol or other central nervous system (CNS) depressants
Hormonal birth control medicines, including pills, implants, patches, or injections

Before taking Qudexy XR, tell your doctor about all of your medical conditions, including if you:

Have or have had depression, mood problems, or suicidal thoughts or behavior
Have kidney problems, kidney stones, or receive kidney dialysis
Have a history of metabolic acidosis
Have liver problems
Have weak or soft bones, including osteomalacia, osteopenia, osteoporosis, or low bone density
Have lung or breathing problems
Have eye problems, especially glaucoma
Have diarrhea
Have growth problems
Are on a ketogenic diet, which is high in fat and low in carbohydrates
Are planning surgery

Qudexy XR may decrease the effectiveness of hormonal birth control and may increase breakthrough bleeding. Tell your doctor if your bleeding pattern changes.

Do not drink alcohol while taking Qudexy XR. Qudexy XR may cause sleepiness, dizziness, or problems with thinking and coordination.

Qudexy XR is also FDA-approved to treat certain types of seizures.

If you miss one dose, take it as soon as you can. If you miss more than one dose, call your doctor.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Qudexy XR, talk with your doctor about the risks and benefits. If you can become pregnant and are not planning a pregnancy, use effective contraception while using Qudexy XR.

Topiramate passes into breast milk. Sleepiness and diarrhea have been reported in breastfed infants exposed to topiramate through breast milk.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Qudexy XR?

In adult migraine prevention studies, people taking topiramate 100 milligrams once daily had fewer migraine headaches than people taking placebo (an inactive treatment). In two studies, migraine headaches decreased by about 2.1 headaches every four weeks with topiramate 100 milligrams once daily, compared with decreases of 0.8 and 1.1 headaches every four weeks with placebo.

With topiramate 200 milligrams once daily, migraine headaches decreased by about 2.2 and 2.4 headaches every four weeks in the same studies.

In studies of people 12 to 17 years old, topiramate 100 milligrams once daily was shown to help prevent migraine. Qudexy XR was approved for migraine prevention based on studies of immediate-release topiramate and studies showing that Qudexy XR gives similar topiramate levels in the body.

How long does Qudexy XR take to work for migraine?

Qudexy XR is started at a low dose and increased over four weeks for migraine prevention. The usual schedule is 25 milligrams in week 1, 50 milligrams in week 2, 75 milligrams in week 3, and 100 milligrams in week 4.

Clinical studies showed that Qudexy XR can help prevent migraine, but the prescribing information does not say exactly how quickly improvement may begin for each person. Response to treatment can vary from person to person.

Can Qudexy XR cause memory problems or trouble thinking when used for migraine?

Yes. Qudexy XR can cause problems with thinking and memory, also called cognitive and neuropsychiatric effects. These side effects may include confusion, trouble concentrating, slowed thinking, and memory problems.

In migraine studies, memory problems were reported more often in people taking Qudexy XR than in people taking placebo. Use caution when driving or operating machinery until you know how Qudexy XR affects you.