Selinexor

Pronunciation: SEL-i-NEX-or
Generic name: selinexor
Brand name: Xpovio
Dosage form: oral tablet
Drug class: Miscellaneous antineoplastics

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 27, 2024.

What is selinexor?

Selinexor (brand name Xpovio) is used to treat multiple myeloma (MM) or certain types of diffuse large B-cell lymphoma (DLBCL) in adults. For MM, selinexor is used in combination with other medicines, and usually when other treatments have not been successful.

Selinexor’s mechanism of action involves targeting a specific protein complex called XPO1, which is responsible for transporting tumor suppressor proteins out of the cell nucleus. Selinexor blocks the removal of these proteins, keeping them in the cell where they can more effectively regulate cell division and trigger cell death in cancer cells.

Selinexor gained FDA approval on July 3, 2019, under the brand name Xpovio. There is no selinexor generic.

Selinexor uses

Selinexor is used to treat:

• multiple myeloma (MM) in combination with the medicines Velcade (bortezomib) and dexamethasone in adults who have received at least one prior treatment for their disease
• multiple myeloma (MM) in combination with dexamethasone in adults whose MM has come back (relapsed) or did not respond to previous treatment (refractory), and
  • who have received at least 4 prior therapies, and
  • whose disease did not respond to (refractory) at least 2 proteasome inhibitor medicines, at least 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody medicine.
• certain types of diffuse large B-cell lymphoma (DLBCL) that has come back (relapsed) or that did not respond to previous treatment (refractory) in adults who have received at least 2 prior therapies

It is not known if selinexor is safe and effective in children less than 18 years of age.

Is selinexor a chemo drug?

No, selinexor is not a chemo drug, it is a targeted treatment that specifically targets the XPO1 (exportin-1) protein, which plays a crucial role in cancer cell growth and survival. By targeting this protein, selinexor has a more focused effect on cancer cells while minimizing damage to healthy cells. selinexor is often used in combination with other medicines to enhance its effectiveness.

Selinexor side effects

Common side effects of selinexor include:

• tiredness
• low red blood cell count (anemia). Symptoms may include tiredness and shortness of breath.
• constipation
• shortness of breath
• increased blood sugar
• changes in body salt and mineral levels in your blood
• changes in kidney and liver function blood tests.

Selinexor may cause fertility problems in males and females, which may affect your ability to have children. Talk to your healthcare provider if you have concerns about fertility.

Serious side effects and warnings

Selinexor can cause the following serious side effects.

Low platelet counts. Low platelet counts are common with selinexor and can lead to bleeding which can be severe and can sometimes cause death. Your healthcare provider may prescribe platelet transfusions or other treatments for your low platelet counts. Tell your healthcare provider right away if you have any bleeding or easy bruising during treatment with selinexor.

Low white blood cell counts. Low white blood cell counts are common with selinexor and can sometimes be severe. You may have an increased risk of getting bacterial infections during treatment with selinexor. Your healthcare provider may prescribe antibiotics if you have signs or symptoms of infection, or certain medicines to help increase your white blood cell count, if needed.

Nausea and vomiting. Nausea and vomiting are common with selinexor and can sometimes be severe. Nausea and vomiting may affect your ability to eat and drink well. You can lose too much body fluid and body salts (electrolytes) and may be at risk for becoming dehydrated. You may need to receive intravenous (IV) fluids or other treatments to help prevent dehydration. Your healthcare provider will prescribe anti-nausea medicines for you to take before you start and during treatment with selinexor.

Diarrhea. Diarrhea is common with selinexor and can sometimes be severe. You can lose too much body fluid and body salts (electrolytes) and may be at risk for becoming dehydrated. You may need to receive IV fluids or other treatments to help prevent dehydration. Your healthcare provider will prescribe anti-diarrhea medicine for you as needed.

Loss of appetite and weight loss. Loss of appetite and weight loss are common with selinexor and can sometimes be severe. Tell your healthcare provider if you have a decrease or loss of appetite and if you notice that you are losing weight at any time during treatment. Your healthcare provider may prescribe medicines that can help increase your appetite or prescribe other kinds of nutritional support. Your healthcare provider will monitor your appetite and weight before you start selinexor and often during the first 3 months, then as needed during treatment.

Decreased sodium levels in your blood. Decreased sodium levels in your blood is common with selinexor but can also sometimes be severe. Low sodium levels in your blood can happen if you have nausea, vomiting, or diarrhea, you become dehydrated, or if you have loss of appetite with selinexor. You may not have any symptoms of a low sodium level. Your healthcare provider may talk with you about your diet and prescribe IV fluids for you based on the sodium levels in your blood. Your healthcare provider will do blood tests before you start taking selinexor, often during the first 2 months of treatment, and then as needed during treatment to monitor the sodium levels in your blood.

Serious infections. Infections are common with selinexor and can be serious and can sometimes cause death. selinexor can cause infections including upper or lower respiratory tract infections, such as pneumonia, and an infection throughout your body (sepsis). Tell your healthcare provider right away if you have any signs or symptoms of an infection such as cough, chills or fever, during treatment with selinexor.

Neurologic side effects. Selinexor can cause neurologic side effects that can sometimes be severe and life-threatening. Selinexor can cause dizziness, fainting, decreased alertness, and changes in your mental status including confusion and decreased awareness of things around you (delirium). In some people, selinexor may also cause problems with thinking (cognitive problems), seeing or hearing things that are not really there (hallucinations), and may become very sleepy or drowsy. Taking other medicines that can cause dizziness or mental status changes during treatment with selinexor may increase your risk of neurologic side effects. Tell your healthcare provider right away if you get any of these signs or symptoms.

New or worsening cataract, a cloudy or loss of transparency of the lens in the eye. New or worsening cataract are common with selinexor. If a cataract forms, your vision may decrease, and you may need eye surgery to remove the cataract and restore your vision. Tell your healthcare provider right away if you have symptoms of a cataract such as double vision, blurred vision, or sensitivity to light or glare.

Your healthcare provider will do blood tests before you start taking selinexor and often during the first 3 months of treatment and then as needed during treatment to monitor you for side effects.

Your healthcare provider may change your dose of selinexor, stop your treatment for some time, or completely stop your treatment if you have certain side effects during treatment with selinexor.

These are not all the possible side effects of selinexor. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking

Before taking selinexor, tell your healthcare provider about all of your medical conditions, including if you:

• have or have had a recent or active infection
• have or have had bleeding problems
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed.

Pregnancy

Selinexor can harm your unborn baby. Females who can become pregnant:

• Your healthcare provider will check to see if you are pregnant before you start taking selinexor
• You should use effective birth control (contraception) during treatment with selinexor and for 1 week after your last dose
• Tell your healthcare provider right away if you become pregnant or think you might be pregnant during treatment with selinexor.

Males with female partners who can become pregnant:

• You should use effective birth control during treatment with selinexor and for 1 week after your last dose.

Breastfeeding

It is not known if selinexor passes into your breast milk. Do not breastfeed during treatment with selinexor and for 1 week after your last dose of selinexor.

How should I take selinexor?

Take selinexor exactly as prescribed by your healthcare provider.

• If you have multiple myeloma, your healthcare provider will prescribe dexamethasone and sometimes bortezomib with your selinexor treatment. Take dexamethasone exactly as prescribed.

Your healthcare provider will tell you how much selinexor to take and when to take it. Do not change your dose or stop taking selinexor without talking to your healthcare provider first.

• Swallow selinexor tablets whole with water. Do not break, chew, crush, or divide the tablets.
• Be sure to take any medicines prescribed by your healthcare provider before and during treatment with selinexor to help prevent nausea and vomiting. Tell your healthcare provider if the prescribed medicine does not control your nausea and vomiting.
• It is important for you to drink enough fluids to help prevent dehydration and to eat enough calories to help prevent weight loss during treatment with selinexor. Talk to your healthcare provider if this is a problem for you.

Selinexor dosage

Selinexor dosage for Multiple Myeloma in combination with bortezomib and dexamethasone (XVd): The recommended dosage is selinexor 100 mg taken orally once weekly in combination with bortezomib and dexamethasone.

Selinexor dosage for Multiple Myeloma in combination with dexamethasone (Xd): The recommended dosage is selinexor 80 mg taken orally on Days 1 and 3 of each week in combination with dexamethasone.

Selinexor dosage for DLBCL: Recommended dosage is selinexor 60 mg taken orally on Days 1 and 3 of each week.

Related/similar drugs

Rituxan, Truxima, Kymriah, Polivy, Xpovio, Yescarta, Monjuvi, Breyanzi, Columvi, Tazverik

What happens if I miss a dose?

If you miss a dose of selinexor, take your next dose at your next regularly scheduled day and time.

If you vomit after taking a dose of selinexor, do not take an extra dose. Take your next dose at your next regularly scheduled day and time.

What happens if I overdose?

If you take too much selinexor, call your healthcare provider right away.

What should I avoid while taking selinexor?

Selinexor can cause neurologic side effects.

If you feel sleepy, dizzy or have any other neurologic side effects with selinexor, do not drive or operate heavy or dangerous machinery until your neurologic side effects go away.

Avoid falling. Use care as needed to avoid falling due to neurologic side effects.

What other drugs will affect selinexor?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Talk with your healthcare provider before taking any new medicines.

How should I store selinexor?

Store selinexor at or below 86°F (30°C).

Selinexor comes in a child-resistant blister pack, keep it in this pack.

Keep out of the reach of children

What are the ingredients in selinexor?

Active ingredient: selinexor

Inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, microcrystalline cellulose, Opadry 200 clear, Opadry II blue, povidone K30, and sodium lauryl sulfate.

Who makes selinexor?

Karyopharm Therapeutics Inc. manufactures selinexor under the brand name Xpovio.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer