Pronunciation: SEL-i-NEX-or
Generic name: selinexor
Brand name: Xpovio
Dosage form: oral tablet (20 mg, 40 mg, 50 mg, 60 mg)
Drug class: Miscellaneous antineoplastics

Medically reviewed by Carmen Pope, BPharm. Last updated on Feb 13, 2025.

What is selinexor?

Selinexor (Xpovio) is a once or twice-weekly tablet for adults with multiple myeloma or resistant diffuse large B-cell lymphoma.

Selinexor was FDA-approved in 2019, but there is no generic version. It is only available under the brand name Xpovio.

FDA approvals

Selinexor is a prescription drug that treats:

• Multiple myeloma - combined with bortezomib and dexamethasone after trying one prior therapy
• Resistant multiple myeloma - combined with dexamethasone after trying four other treatments including proteasome inhibitors, immunomodulators, and anti-CD38 antibodies
• Resistant diffuse large B-cell lymphoma - after trying at least two other treatments

Note that the approval for DLBCL is under the accelerated approval designation. Continued approval for this indication may be contingent upon a clinical benefit being shown in further clinical trials.

It is unknown if selinexor is safe and effective in children under 18 years of age.

Is selinexor chemotherapy?

Selinexor is a targeted therapy, not chemotherapy. It boosts the body's natural cancer defences by focusing on cancer cells while sparing healthy ones. It works best for MM when combined with other medications.

How does selinexor work?

Selinexor blocks XPO1, a protein that removes tumor suppressors from cell nuclei. This causes XPO1 buildup, triggering cancer cell death while protecting normal cells. It's the first selective inhibitor of nuclear export (SINE) drug to be developed.

Selinexor side effects

Common selinexor side effects include fatigue, anemia, constipation, breathing problems, high blood sugar, altered blood mineral levels, and abnormal kidney/liver tests.

It may affect fertility in both men and women - discuss concerns with your doctor.

Serious side effects and warnings

Selinexor can cause the following serious side effects.

Low platelets - Common and potentially fatal, causing bleeding and bruising. Some patients may need platelet transfusions. Alert your doctor if bleeding occurs.

Low white blood cells - Common and sometimes severe, increasing infection risk. Some patients may need antibiotics or medications to boost counts.

Nausea and vomiting - Common and potentially severe, risking dehydration and electrolyte loss. Some patients need IV fluids and anti-nausea drugs before starting treatment.

Diarrhea - Common and sometimes severe, risking dehydration and electrolyte loss. Some patients need IV fluids and anti-diarrhea medication.

Appetite and weight loss - Common and potentially severe. Your doctor will monitor you for this during the first 3 months and may prescribe appetite stimulants or nutritional support.

Low blood sodium - Common and sometimes severe, especially with nausea/vomiting, diarrhea, or poor appetite. Some patients may need IV fluids. Blood tests are required at the start of treatment, for the first 2 months, and then as needed.

Serious infections - Common and potentially fatal, including respiratory infections and sepsis. Report any fever, cough, or chills immediately.

Neurologic effects - Can be severe or life-threatening. May cause dizziness, fainting, confusion, cognitive issues, hallucinations, or drowsiness. Other medications may increase these risks.

Cataracts - Common, may need surgery if vision decreases. Report vision changes, light sensitivity, or glare.

Regular blood tests are required in the first 3 months then as needed. Your doctor may adjust your dose, pause, or stop treatment based on side effects.

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.

Related/similar drugs

Before taking

Before taking selinexor, tell your doctor 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.

For 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 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.

How should I take selinexor?

Take selinexor exactly as prescribed by your healthcare provider.

• Take selinexor 1 or 2 times a week. Your healthcare provider will tell you how often to take it. 
• If your doctor has prescribed other treatments, such as dexamethasone and/or bortezomib, take them 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.

Selinexor may make you feel sick (nauseous) and you may vomit.

• Be sure to take medicines to help prevent nausea and vomiting that have been prescribed by your healthcare provider before and during treatment with selinexor.
• Tell your healthcare provider if the prescribed medicine does not control your nausea and vomiting.
• Drink enough fluids to help prevent dehydration and eat enough calories to help prevent weight loss during treatment with selinexor. Talk to your healthcare provider if this is a problem for you.

Dosing information

Dosage for Multiple Myeloma in combination with bortezomib and dexamethasone (XVd):

• Selinexor 100 mg once weekly in combination with bortezomib and dexamethasone.

Dosage for Multiple Myeloma in combination with dexamethasone (Xd):

• Selinexor 80 mg on Days 1 and 3 of each week (2 times weekly) in combination with dexamethasone.

Dosage for DLBCL:

• Selinexor 60 mg on Days 1 and 3 of each week (2 times weekly).

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. Do not drive or operate heavy or dangerous machinery if you feel sleepy, dizzy or have any other neurologic side effects with selinexor until the side effects go away. These side effects may also increase your risk of falls. Remove any trip hazards.

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 tablets at or below 86°F (30°C). Keep in their original child-resistant blister 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. Their headquarters are in Massachusetts. Founded in 2008, the company focuses on improving the lives of people with cancer.

Xpovio (selinexor) is their main product.

Further information

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

Medical Disclaimer