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    Adverse reactions (ARs) with XPOVIO® (selinexor) 80 mg + dexamethasone 20 mg administered twice weekly1

    ARs 
    (≥10%)
    Any 
    Grade
    (N = 202) 
    n (%)
    Grade ≥3
    (N = 202) 
    n (%)
    Thrombocy­topeniaa 149 (74) 124 (61)
    Fatigueb 147 (73) 44 (22)
    Nausea 146 (72) 18 (9)
    Anemiac 119 (59) 81 (40)
    Decreased appetite 108 (53) 9 (4.5)
    Weight decreased 95 (47) 1 (0.5)
    Diarrhea 89 (44) 13 (6)
    Vomiting 82 (41) 7 (3.5)
    Hyponatre­mia 78 (39) 44 (22)
    Neutropeniad 68 (34) 43 (21)
    Leukopenia 57 (28) 23 (11)
    Constipation 50 (25) 3 (1.5)
    Dyspneae 48 (24) 7 (3.5)f
    Upper respiratory tract infectiong 42 (21) 6 (3)
    Coughh 33 (16) 0
    Mental status changesi 33 (16) 14 (7)
    Pyrexia 32 (16) 1 (0.5)
    Hyperglyce­mia 31 (15) 15 (7)
    Dizziness 30 (15) 0
    Insomnia 30 (15) 4 (2)
    Lymphope­nia 30 (15) 20 (10)
    Dehydration 28 (14) 7 (3.5)
    Hypercreatini­nemiaj 28 (14) 4 (2)
    Pneumoniak 26 (13) 18 (9)f
    Epistaxis 25 (12) 1 (0.5)
    Hypokalemia 25 (12) 7 (3.5)
    Dysgeusia 22 (11) 0
    Vision blurred 21 (10) 1 (0.5)
    Headache 20 (10) 0
    ARs (≥10%)
    (cont’d)
    Any Grade
    (N = 202) n (%)
    Grade ≥3
    (N = 202) n (%)
    Mental status changesi 33 (16) 14 (7)
    Pyrexia 32 (16) 1 (0.5)
    Hyperglycemia 31 (15) 15 (7)
    Dizziness 30 (15) 0
    Insomnia 30 (15) 4 (2)
    Lymphopenia 30 (15) 20 (10)
    Dehydration 28 (14) 7 (3.5)
    Hypercreatininemiaj 28 (14) 4 (2)
    Pneumoniak 26 (13) 18 (9)f
    Epistaxis 25 (12) 1 (0.5)
    Hypokalemia 25 (12) 7 (3.5)
    Dysgeusia 22 (11) 0
    Vision blurred 21 (10) 1 (0.5)
    Headache 20 (10) 0

    aThrombocytopenia includes thrombocytopenia and platelet count decreased.

    bFatigue includes fatigue and asthenia.

    cAnemia includes anemia and hematocrit decreased.

    dNeutropenia includes neutropenia and neutrophil count decreased.

    eDyspnea includes dyspnea, dyspnea exertional, and dyspnea at rest.

    fIncludes fatal event.

    gUpper respiratory tract infection includes upper respiratory tract infection, respiratory tract infection, pharyngitis, nasopharyngitis, bronchitis, bronchiolitis, respiratory syncytial virus infection, parainfluenza virus infection, rhinitis, rhinovirus infection, and adenovirus infection.

    hCough includes cough, productive cough, and upper-airway cough syndrome.

    iMental status changes includes mental status changes, confusional state, and delirium.

    jHypercreatininemia includes hypercreatininemia and hypercreatinemia.

    kPneumonia includes pneumonia, atypical pneumonia, lung infection, lower respiratory tract infection, pneumocystis jirovecii pneumonia, pneumonia aspiration, pneumonia influenzal, and pneumonia viral.

    See the dose modification guidelines for the management of ARs

    Learn More
    • The treatment discontinuation rate due to ARs was 27%
    • Reduction or interruption of XPOVIO dose occurred in 53% and 65.3% of patients, respectively
    • The most frequent ARs requiring permanent discontinuation in ≥4% of patients included fatigue, nausea, and thrombocytopenia
    • The rate of fatal ARs was 8.9%

    Recommended monitoring for safety

    • Monitor at baseline and during treatment as clinically indicated:
      • Complete blood count (CBC)
      • Standard blood chemistry
      • Body weight
    • Monitor more frequently during the first 2 months of treatment

    Recommended concomitant treatments

    • Advise patients to maintain adequate fluid and caloric intake throughout treatment
    • Consider intravenous 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 treatment with XPOVIO

    Reference: 1. XPOVIO (selinexor) [package insert]. Newton, MA: Karyopharm Therapeutics Inc.; July 2019.