selinexor at a glance
Medicine class
Selective inhibitor of nuclear export and antineoplastic agent.
Main use
Previously treated multiple myeloma in adults, as part of combination treatment.
How it is taken
Swallow the tablet whole with water, with or without food.
Specialist oversight
Treatment is started and monitored by clinicians experienced in managing multiple myeloma.
What is selinexor used for?
Licensed uses in adults with multiple myeloma are:
With bortezomib and dexamethasone after at least one previous therapy.
With dexamethasone after at least four previous therapies when disease meets the licence’s specified refractory and progression criteria.
How does selinexor work?
Selinexor blocks exportin-1, a protein that transports selected molecules out of the cell nucleus. This retains tumour-suppressing proteins in the nucleus, reduces certain growth-promoting proteins and can cause myeloma cells to stop dividing and die.
How to take selinexor
Follow the written schedule supplied by the specialist cancer team.
Take it at approximately the same time on each scheduled treatment day.
Swallow tablets whole with water.
Do not crush, chew, break or divide them because the active substance may irritate the skin.
It may be taken with or without food.
Maintain fluid and calorie intake as advised by the treatment team.
selinexor side effects
Common or expected effects
- Nausea, vomiting, diarrhoea or constipation
- Reduced appetite, weight loss or dehydration
- Fatigue or weakness
- Low platelets, red blood cells or neutrophils
- Infections, including respiratory infections
- Dizziness, headache or sleep disturbance
- Blurred vision or cataract
- Altered sodium or other electrolyte levels
- Peripheral neuropathy, particularly with bortezomib-containing treatment
Get urgent medical advice
- Fever or other signs of a serious infection
- Unexpected bleeding, persistent nosebleeds, blood in urine or stools, or extensive bruising
- Severe dehydration or inability to keep fluids down
- New severe confusion, fainting, hallucinations or seizures
- Severe breathlessness
- Symptoms suggesting tumour lysis syndrome, such as muscle cramps, weakness, confusion or breathlessness
selinexor in pregnancy
Selinexor is not recommended during pregnancy because animal evidence indicates potential fetal harm and human data are unavailable. Pregnancy testing is recommended before treatment where relevant, and effective contraception is advised for patients who could conceive or father a child during treatment and for at least one week afterwards. A pregnancy during treatment requires immediate contact with the specialist team.
selinexor while breastfeeding
Breastfeeding should stop during selinexor treatment and for one week afterwards because transfer into human milk is unknown and harm to a breastfed child cannot be excluded.
selinexor interactions
The cancer team should review prescribed, over-the-counter and complementary products before treatment.
Bortezomib and dexamethasone
Their separate contraindications, interactions, supportive-care requirements and adverse effects also apply when used with selinexor.
Medicines that cause dizziness or confusion
They may worsen selinexor-related impairment, so concurrent use should be reviewed by the treatment team.
Carbamazepine, clarithromycin and paracetamol
Product studies found no clinically significant change in selinexor exposure with the studied use of these medicines; this does not replace an individual interaction review.
Common questions about selinexor
Answers are fully visible for fast scanning and source review.
Is selinexor chemotherapy?
It is an antineoplastic treatment, but more specifically a targeted selective inhibitor of nuclear export rather than conventional cytotoxic chemotherapy.
Why is selinexor given with other myeloma treatments?
Its licensed uses are combination treatments. Laboratory and clinical evidence supports complementary activity with dexamethasone and, in one licensed setting, bortezomib.
Can selinexor be taken with food?
Yes. The tablets may be taken with or without food.
Can selinexor tablets be crushed or split?
No. Swallow them whole because breaking, crushing, chewing or dividing them can expose skin to an irritant active substance.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.