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Generic Name: selinexor (SEL i NEX or)
Brand Names: Xpovio

Medically reviewed by Judith Stewart, BPharm. Last updated on Aug 4, 2020.

What is Xpovio?

Xpovio (selinexor) is used to treat multiple myeloma in adults.

Xpovio is given together with a steroid medicine called dexamethasone and is given after other specific medications did not work or have stopped working.

Xpovio is also used in adults to treat certain types of diffuse large B-cell lymphoma.

Xpovio was approved by the US Food and Drug Administration (FDA) on an "accelerated" basis. In clinical studies, some people responded to this medicine, but further studies are needed.

Important Information

Xpovio affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, flu symptoms, cough, mouth ulcers, or trouble breathing,

Selinexor can also cause low platelet counts in your blood. Tell your doctor right away if you have unusual bruising or bleeding.

Before taking this medicine

To make sure Xpovio is safe for you, tell your doctor if you have ever had:

  • bleeding problems; or

  • an active or recent infection.

You may need to have a negative pregnancy test before starting this treatment.

Both men and women using this medicine should use effective birth control to prevent pregnancy. Selinexor can harm an unborn baby if the mother or father is using this medicine.

Keep using birth control for at least 1 week after your last dose. Tell your doctor right away if a pregnancy occurs while either the mother or the father is using Xpovio.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because selinexor can harm an unborn baby.

Do not breastfeed while using this medicine, and for at least 1 week after your last dose.

Xpovio is not approved for use by anyone younger than 18 years old.

How should I take Xpovio?

Xpovio is usually taken with dexamethasone on just 2 specific days each week. Follow your doctor's dosing instructions very carefully. Take your medicines at the same time each dosing day. Your doctor will determine how long to treat you with Xpovio and dexamethasone.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using Xpovio.

Take this medicine with a full glass of water. Swallow the tablet whole and do not crush, chew, or break it.

If you vomit shortly after taking Xpovio, do not take another dose. Wait until your next scheduled dose time to take the medicine again.

You may be given other medications to help prevent nausea, vomiting, or infections. Tell your doctor if you think these medications are not working well. Keep using all of your medicines for as long as your doctor has prescribed.

Selinexor can lower your blood cell counts. You may get infections more easily, even serious or fatal infections. Your blood will need to be tested often. Your treatments may be delayed based on the results. You may need a transfusion if your blood platelets get too low.

Selinexor can lower your sodium levels. This may not cause any symptoms so your blood will need to be tested. If your sodium levels get too low, your doctor may prescribe salt tablets or intravenous (IV) fluids to keep you from getting dehydrated.

Drink plenty of liquids to prevent dehydration, and eat enough calories to prevent weight loss.

Xpovio can affect your appetite or ability to eat. You will be weighed before and during treatment to make sure you are not losing weight while taking this medicine.

Store at room temperature away from moisture and heat. Keep each Xpovio tablet in the blister pack until you are ready to take your dose.

Xpovio dosing information

Usual Adult Dose for Multiple Myeloma:

80 mg orally on Day 1 and 3 of each week until disease progression or unacceptable toxicity
-The recommended starting dosage of dexamethasone is 20 mg orally with each dose of this drug Day 1 and 3 of each week

-For additional information regarding the administration of dexamethasone, refer to its prescribing information.
-Consider IV hydration for patients at risk of dehydration.
-Provide prophylactic concomitant treatment with a 5-HT3 antagonist and/or other anti-nausea agents prior to and during therapy.

Use: In combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least 4 prior therapies and whose disease is refractory to at least 2 proteasome inhibitors, at least 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Xpovio?

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Xpovio side effects

Get emergency medical help if you have signs of an allergic reaction to Xpovio: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Selinexor can cause serious or fatal side effects. Some side effects may not occur until you have been taking this medicine for several days or weeks.

Call your doctor at once if you have:

  • severe ongoing nausea, vomiting, or diarrhea;

  • loss of appetite that prevents you from eating and causes weight loss;

  • confusion, dizziness, fainting, or changes in mental status;

  • easy bruising, unusual bleeding, purple or red spots under your skin;

  • signs of infection - fever, chills, flu symptoms, cough with mucus, mouth and throat ulcers, rapid heart rate, feeling short of breath, tingly or painful blistering rash on one side of your body;

  • low red blood cells (anemia) - pale skin, unusual tiredness, feeling light-headed, cold hands and feet; or

  • low sodium level - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Your treatments may be delayed or permanently discontinued if you have certain side effects.

Common Xpovio side effects may include:

  • tiredness;

  • anemia, bruising or bleeding;

  • fever, infections, cold or flu symptoms;

  • low sodium;

  • nausea, vomiting, loss of appetite;

  • diarrhea, constipation;

  • weight loss; or

  • shortness of breath.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Xpovio?

Other drugs may interact with selinexor, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Xpovio only for the indication prescribed.

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