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Xpovio (selinexor) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with multiple myeloma. It is used with other medicines in certain approved treatment settings.
These insights are based on 108 comments about Xpovio from MyMyelomaTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Xpovio is a type of medicine called a nuclear export inhibitor. It works by blocking a protein called exportin 1. This helps keep tumor-fighting proteins inside the cell and lowers proteins that help cancer grow.
This can lead to cancer cell death. By targeting this pathway, the medication may help manage symptoms and slow disease activity.
Doctors prescribe Xpovio with certain other medicines, bortezomib and dexamethasone, for adults with multiple myeloma who have had at least one prior treatment or whose myeloma has come back or not responded after several prior treatments.
Xpovio is a tablet taken by mouth. Take each dose at about the same time of day. Swallow the tablet whole with water.
Do not break, chew, crush, or split the tablet.
Xpovio is used in different ways depending on your treatment plan.
With bortezomib and dexamethasone (XVd), Xpovio is used for adults with multiple myeloma who have had at least one prior treatment. The usual dose is 100 milligrams taken by mouth once a week on day 1 of each week.
It is used with:
Treatment continues until the disease gets worse or side effects are not manageable.
With dexamethasone alone (Xd), Xpovio is used for adults with refractory myeloma that has come back or not responded after at least four prior treatments.
The usual dose is 80 milligrams taken by mouth on days 1 and 3 each week. Dexamethasone, 20 milligrams, is taken with each Xpovio dose on those same days.
Dose changes: If side effects occur, the dose may be lowered step by step to 80 milligrams once weekly, then 60 milligrams once weekly, and then 40 milligrams once weekly. If needed, treatment may be stopped. Your doctor may adjust your treatment plan based on your needs.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 108 comments about Xpovio from MyMyelomaTeam members.Members who use Xpovio often say it helps to plan for side effects, keep in close touch with the care team, and watch how they feel in the days after each dose. Many also mention that response and tolerability can vary a lot. Members often focus on tracking symptoms, lab results, and treatment logistics with their doctor.
Get blood work and follow lab changes closely.
“Just got my lab results after being on it for a month, and my numbers have come down some, so it’s working.”
Be aware of nausea, appetite changes, and taste changes.
“My taste buds are still off. Like someone said, most foods are like eating a wet paper towel.”
Tell your doctor about side effects that are hard to manage.
“After trying several anti-nausea meds and not having them help, they have cut his dose of selinexor in half to manage the side effects.”
Connect with others who understand life with multiple myeloma. Join MyMyelomaTeam for free.
In clinical studies of adults with multiple myeloma, including people whose disease had come back or not responded to treatment, Xpovio was used with other medicines. The most common side effects occurred in about 21 percent to 59 percent of people. These were:
Xpovio can cause serious side effects that require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Karyopharm Therapeutics, the manufacturer of Xpovio, offers the KaryForward patient support program. Eligible people with commercial insurance may pay as little as $5 for each Xpovio prescription.
The KaryForward program also provides support with insurance coverage, including understanding benefits, filing claims, and help during appeals, financial assistance, including the Xpovio Copay Program and, for eligible people, access to Xpovio at no cost. Nurse case managers are available to provide education, prescription guidance, ongoing support, and referrals to third-party services such as transportation assistance.
To learn more, visit the KaryForward patient support program website or call 877-527-9493.
Before starting Xpovio, your doctor will check your blood counts (CBC with differential), blood chemistry (including sodium), body weight, nutrition, and fluid levels. These will also be checked during treatment.
Before the dose of Xpovio, you may be given medicines to help prevent nausea and vomiting. It is important to drink enough fluids and eat enough food during treatment.
Tell your doctor if you have any allergies to selinexor or any ingredients in Xpovio.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Also let your doctor know if you have signs of infection or symptoms like dizziness or confusion.
If you miss a dose, take your next dose at the regular time. If you vomit after taking a dose, do not take another dose. Take your next dose as scheduled.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Xpovio, talk with your doctor about the risks and benefits. Xpovio can harm a baby. Your doctor should check if you are pregnant before starting treatment.
Use effective birth control during treatment and for one week after your last dose. This applies to females who can become pregnant and to males with partners who can become pregnant. Do not breastfeed during treatment and for one week after your last dose.
These answers are fact-checked by our editorial staff.
How effective is Xpovio?
In a study of adults with multiple myeloma who had one to three prior treatments, people who took Xpovio with bortezomib and dexamethasone lived about 13.9 months without their disease getting worse, compared to 9.5 months without Xpovio. About 76.4 percent of people responded to the Xpovio combination, compared to 62.3 percent without it. Many people responded in about 1.4 months.
In another study of people whose myeloma had been heavily treated, Xpovio with dexamethasone had a response rate of 25.3 percent. The first response was seen in about four weeks.
How long does Xpovio take to work for multiple myeloma?
In one study, people responded in about 1.4 months. In another study, people responded in about four weeks.
Can Xpovio cause nausea or vomiting in multiple myeloma?
Yes. Nausea and vomiting are common. Medicines to prevent nausea are given before and during treatment.
What tests or monitoring are needed with Xpovio for multiple myeloma?
Your doctor will check your blood counts, blood chemistry, body weight, nutrition, and fluid levels before and during treatment. These tests are done more often during the first three months. Sodium levels are also checked regularly.
On MyMyelomaTeam, people share their experiences with multiple myeloma, get advice, and find support from others who understand.
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