Brand Reference: Topamax, Trokendi XR
| Metric | Verified Benchmark | Source |
|---|---|---|
| Topiramate RxNorm Concept ID | 38404 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.0390 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $34.00 / mo | CMS NADAC + U.S. Retail Markup Index |
| Mark Cuban Cost Plus Wholesale Price | $5.20 / mo | Cost Plus Drugs Wholesale Feed |
| Community Mean Out-of-Pocket Paid | $6.50 / mo | 28 Zero-PHI Verified Patient Logs |
Dampens cortical spreading depression and hypothalamic binge-craving circuits via four mechanisms: voltage-gated Na+ blockade, kainate/AMPA glutamate receptor antagonism, GABA-A chloride flux augmentation, and weak carbonic anhydrase II/IV inhibition.
Out-of-pocket price dispersion on Topiramate spans $5.20 to $34.00 per 30-day fill: pharmacy acquisition benchmarks sit near $0.0390/unit, allowing cash buyers bypassing PBM spread pricing to retain $28.80 each month (85% reduction).
With 21 hours residence kinetics and 80% oral bioavailability, Topiramate undergoes 70% excreted unchanged in urine and establishes therapeutic activity over 4 weeks migraine prophylaxis & appetite suppression.
Standard adult regimens span 25 mg PO QHS week 1, 50 mg PO QHS (or 25 mg BID), 50 mg PO BID migraine target. Prescribers screen specifically against pregnancy (oral cleft teratogenicity); recurrent calcium-phosphate nephrolithiasis without citrate hydration; metabolic acidosis, while community micro-logs most frequently note fingertip tingling paresthesia (39% of reports), carbonated beverage flat taste (32% of reports), word-retrieval slowing (27% of reports).
Across 28 verified cash-pay logs, Topiramate achieves a 73.80% Worth-It rating with out-of-pocket spend averaging $6.50/mo versus $34.00/mo walk-in retail.
Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.
Switched to Cost Plus Drugs at 25 mg PO QHS week 1 for Topiramate; monthly out-of-pocket dropped to $4.58 compared with $34.00 retail.
Completed 10 weeks on Topiramate (50 mg PO QHS (or 25 mg BID)). Zero notable side effects on steady dosing.
Consistent biomarker response on 50 mg PO BID migraine target Topiramate sourced via Cost Plus Drugs ($6.03/mo cash pay without insurance prior authorization).