Xpovio is a brand-name prescription medication. It’s FDA-approved for use as treatments for the following types of cancer:

  • Multiple myeloma (MM) in adults who have already tried at least one treatment for their MM. For this use, Xpovio is taken with bortezomib (Velcade) and dexamethasone (Decadron).
  • Relapsed or refractory* multiple myeloma (RRMM) in adults who have already tried at least four treatments for their RRMM. These treatments must be from specific classes of drugs† that the cancer didn’t respond to. For this use, Xpovio is taken with dexamethasone.
  • Diffuse large B cell lymphoma (DLBCL) that’s relapsed or refractory* in adults who have already tried at least two treatments for their DLBCL.

* “Relapsed” means the cancer has come back after remission (a period of time when no cancer was detected). “Refractory” means the cancer didn’t respond (shrink or go away) to a previous treatment.
† A class of drugs is a group of medications that work in a similar way.

For more information about the uses of Xpovio, see the “Xpovio uses” section below.

Drug details

Xpovio contains the active drug selinexor. It’s a selective inhibitor of nuclear export (SINE), and it’s the first FDA-approved drug in this class. (A class of drugs is a group of medications that work in a similar way.)

This drug is used to treat certain forms of cancer, but it’s not chemotherapy. It’s a type of cancer treatment known as targeted therapy. These therapies work to treat cancer by blocking specific targets in your cells. For more information, see the “How Xpovio works” section below.

Xpovio is a tablet that you take by mouth. It comes in one strength: 20 milligrams (mg).

FDA approval

Xpovio was initially approved by the Food and Drug Administration (FDA) in 2019. At that time, it was approved for only one type of cancer, multiple myeloma.

For its use for DLBCL, Xpovio received accelerated approval from the FDA in June 2020.

Drugs typically receive approval from the FDA only after extensive studies have been fully completed. But for some drugs, such as Xpovio, the FDA grants approval before all of the studies are done. A drug can get this “fast-track” approval if there aren’t many effective medications for the condition it treats. This is the case for relapsed and refractory DLBCL.

Accelerated approval for Xpovio is based on information from early clinical trials of the drug. The FDA will make its decision for full approval of Xpovio after additional clinical trials have been done.

Effectiveness

For information about the effectiveness of Xpovio, see the “Xpovio uses” section below.

Xpovio is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Xpovio can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Xpovio. These lists do not include all possible side effects.

For more information about the possible side effects of Xpovio, talk with your doctor or pharmacist. They can give you tips on dealing with any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks the side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Xpovio, you can do so through MedWatch.

Mild side effects

Mild side effects* of Xpovio can vary based on the condition it’s used to treat and whether it’s taken with certain other drugs. But in general, mild side effects include:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Xpovio. To learn about other mild side effects, talk with your doctor or pharmacist, or view Xpovio’s medication guide.
† For more information about this side effect, see “Digestive side effects” under “Side effect details” below.

Serious side effects

Most serious side effects from Xpovio aren’t common, but they can occur in some people. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Xpovio’s serious side effects can vary based on the condition it’s used to treat and whether it’s taken with certain other drugs. But in general, serious side effects include:

  • Serious infection, such as pneumonia or sepsis (an infection that affects your whole body). Symptoms of a serious infection can include:
  • Cataracts (clouding of the lens in your eye). Symptoms can include:
    • blurred or double vision
    • sensitivity to light
  • Shortness of breath. Symptoms can include:
    • trouble breathing
    • feeling out of breath without any explanation (such as energetic exercise)
  • Hyponatremia (low sodium level).
  • Changes in kidney and liver function tests.
  • Fever.
  • Severe digestive side effects.*
  • Low blood cell counts.*
  • Neurological (brain-related) problems.*
  • Allergic reaction.*

* For more information about this side effect, see “Side effect details” below.

Side effect details

Here’s some detail on certain side effects this drug may cause.

Digestive side effects

Digestive side effects were some of the most common side effects in clinical studies of Xpovio. These include side effects such as:

For some people, these side effects may be mild, but they can be severe for others.

Severe digestive side effects from Xpovio can lead to other side effects. These include weight loss, dehydration, or low sodium level.

To find out more details about how often digestive side effects occurred in clinical studies, see Xpovio’s prescribing information.

You shouldn’t stop or change your treatment without discussing it with your doctor. If you have questions about digestive side effects with Xpovio, consult your doctor or pharmacist.

Treating or preventing digestive side effects

Along with Xpovio, your doctor will likely prescribe medications to help prevent or reduce nausea and vomiting. Examples include ondansetron (Zofran), rolapitant (Varubi), and olanzapine (Zyprexa).

Some of these drugs come in forms (such as a skin patch) that don’t require you to take them by mouth. These may be better choices if you can’t keep oral medications down.

If your digestive side effects aren’t relieved with treatment or become severe, talk with your doctor. They may prescribe different antinausea treatments or suggest home remedies to try. They may also have you take a lower dosage of Xpovio. Or they may have you stop taking the drug temporarily or permanently.

Low blood cell counts

Low blood cell counts were common in clinical studies of Xpovio.

Depending on which types of blood cell you have low counts for, you can develop different conditions. The conditions that can commonly occur with Xpovio are described below, along with their specific symptoms.

Thrombocytopenia

Thrombocytopenia results from a low platelet count. Platelets are a type of blood cell that forms clots to help you stop bleeding after an injury. A slightly low platelet count doesn’t usually cause a problem. But if your platelet count becomes severely low, you may have symptoms. These include:

Neutropenia

A low level of neutrophils, a type of white blood cell, can lead to neutropenia. White blood cells help to fight off infection. If Xpovio treatment decreases your levels of neutrophils and other white blood cells, you’ll have an increased risk for infections. This includes serious infections, such as pneumonia or sepsis, that may lead to death.

It’s important to call your doctor right away if you develop symptoms of infection. These include:

  • fever greater than 100.4°F (38°C) for at least 60 minutes*
  • chills
  • diarrhea or vomiting
  • cold-like symptoms, such as sore throat, cough, congestion, sneezing
  • flu-like symptoms, such as body aches
  • swelling, irritation, or wounds that are draining fluid

* This symptom could be the result of febrile neutropenia (fever with decreased neutrophil levels). This is a medical emergency that could lead to sepsis, a life threatening condition. If you think you have febrile neutropenia, call 911 or go to an emergency room right away.

Anemia

Anemia can result from a low red blood cell count. Red blood cells carry oxygen from your lungs to the rest of your body. Mild anemia usually causes few symptoms. But as anemia becomes more severe, symptoms that may develop include:

Monitoring and treating low blood cell counts

A blood test known as a complete blood count (CBC) measures the amounts of the different blood cell types. Your doctor will monitor your blood cell counts with CBC tests before you start taking Xpovio. They’ll recheck these counts frequently during the first 3 months of treatment. And you’ll keep getting these tests regularly while you’re taking Xpovio.

If you develop low blood cell counts, your doctor will treat you based on the severity of your condition. Treatments can include blood transfusions, antibiotics, or other treatments. Your doctor may also lower your dosage of Xpovio or have you pause or stop treatment. But don’t stop or change your dosage without talking with your doctor.

To find out more about how often low blood cell counts occurred in clinical studies, see Xpovio’s prescribing information. If you have questions about low blood cell counts with Xpovio, talk with your doctor or pharmacist.

Neurological problems

In clinical studies, some people experienced neurological problems as a side effect of Xpovio. “Neurological problems” is a term used to describe a variety of symptoms related to brain function. Examples of such problems that were reported in clinical studies of Xpovio include:

Overall, these were common side effects during clinical studies of Xpovio. For some people, these problems were mild or temporary. Less commonly, these side effects were severe or, in rare instances, life threatening.

Your risk of having brain-related problems with Xpovio may be higher if you take other medications that also cause such problems. Be sure to discuss your current medications with your doctor before starting Xpovio.

If any of these symptoms become severe or don’t go away, call your doctor. If your symptoms feel life threatening, call 911 or seek emergency medical care.

If you develop brain-related problems while taking Xpovio, let your doctor know. They may treat you to correct the problem, lower your dosage of Xpovio, or have you stop taking the drug.

Lowering your risk for injury

Brain-related side effects can increase the risk of falling or another accidental injury. It may also be unsafe for you to do certain activities, such as driving.

After starting Xpovio, you shouldn’t drive or operate dangerous or heavy machinery. Wait until you’ve been taking Xpovio long enough to know how it affects you. In studies of Xpovio, brain-related problems usually began within the first month of starting treatment. But they could occur sooner or later.

Ask your doctor about what other activities you should avoid while taking Xpovio. Also, ask your doctor about when it might be safe for you to resume such activities.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Xpovio. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth or redness/deepening of skin color for a brief time)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Xpovio, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

As with all medications, the cost of Xpovio can vary. To find current prices for Xpovio in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Xpovio. If approved by your insurance company, a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

It’s important to note that you’ll have to get Xpovio at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These drugs may be expensive, or you may require help from healthcare providers to use them safely and effectively.

Before approving coverage for Xpovio, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Xpovio, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Xpovio, or if you need help understanding your insurance coverage, help is available.

Karyopharm, the manufacturer of Xpovio, offers a program called KaryForward. For more information and to find out if you’re eligible for support, call 877-KARY4WD (877-527-9493) or visit the program website.

Mail-order pharmacies

Xpovio may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Xpovio, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Xpovio isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Xpovio is approved to treat multiple myeloma (MM) and diffuse large B-cell lymphoma (DLBCL).* It’s a type of cancer treatment called targeted therapy.† This type of treatment works by seeking out cells with specific targets, such as certain proteins, and attaching to them.

Xpovio targets cells that contain a protein known as XPO1. Some cancers have high levels of this protein. Once Xpovio attaches to its target, the drug inhibits (blocks) the XPO1 protein from functioning. This eventually kills the cancer cells.

Xpovio is the first FDA-approved targeted therapy with this specific mechanism of action. (“Mechanism of action” means how the drug works.)

To learn more about how Xpovio works to treat certain cancers, see the manufacturer’s website.

* Certain factors need to be considered before Xpovio can be used to treat these cancers. For more information, see the “Xpovio uses” section below.
† Specifically, Xpovio belongs to a drug class called selective inhibitors of nuclear export (SINE). A drug class is a group of medications that work in a similar way.

How long does it take to work?

Xpovio begins working as soon as you start taking it. But you aren’t likely to feel the drug working right away.

In clinical studies of Xpovio, some people’s cancer showed a response to the drug after 1 to 2 months. How long it takes Xpovio to work may depend on the type of cancer being treated. Some people may see improvement in their condition sooner, while for others, it may take longer.

For more details on these results, see Xpovio’s prescribing information.

The Xpovio dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of your cancer
  • other medications you’re taking

Typically, your doctor will start you on a high dosage of Xpovio. If you experience bothersome or serious side effects, they’ll lower your dosage to find the amount that’s right for you. Your doctor will ultimately prescribe the highest dosage that doesn’t cause unmanageable side effects.

Xpovio is a tablet that you take on a dosing schedule. How often you’ll take it depends on the condition you’re treating, as discussed below.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best starting dosage to fit your needs. If you experience bothersome side effects, your doctor may lower your dosage over time to find the amount that’s right for you.

Drug forms and strengths

Xpovio comes as a tablet that you swallow. It’s available in one strength: 20 milligrams (mg).

Dosage for multiple myeloma

Xpovio is approved to treat:

The dosage of Xpovio you take will depend on which of these conditions you’re treating.

* Certain factors need to be considered before Xpovio can be used to treat MM or RRMM. For more information, see the “Xpovio uses” section below.
† “Relapsed” means the cancer has come back after remission (a period of time when no cancer was detected). “Refractory” means the cancer didn’t respond (shrink or go away) to a previous treatment.

Dosage when used with dexamethasone and bortezomib for MM

When Xpovio is used with dexamethasone and bortezomib to treat MM, the usual starting dose is 100 mg (five tablets). You’ll take this dose once each week.

Dosage when used with dexamethasone for RRMM

When Xpovio is used with dexamethasone to treat RRMM, the usual starting dosage is 80 mg (four tablets). You’ll take this dose twice each week, on days 1 and 3.

Dosage for diffuse large B cell lymphoma

Xpovio is also used to treat diffuse large B cell lymphoma (DLBCL)* that’s relapsed or refractory.† For this use, the usual starting dosage is 60 mg (three tablets). You’ll take this dose twice each week, on days 1 and 3.

* Certain factors need to be considered before Xpovio can be used to treat DLBCL. For more information, see the “Xpovio uses” section below.
† “Relapsed” means the cancer has come back after remission (a period of time when no cancer was detected). “Refractory” means the cancer didn’t respond (shrink or go away) to a previous treatment.

What if I miss a dose?

If you miss a dose of Xpovio, take your next dose at your regularly scheduled day and time. You don’t need to take an extra dose or change your dosing schedule.

If you vomit after taking your dose of Xpovio, you shouldn’t take another dose right away. Take your next dose at your regularly scheduled day and time.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

Will I need to use this drug long term?

Xpovio is meant to be used as a long-term treatment. It’s possible you’ll take it until your cancer gets worse or you experience side effects that are hard to manage.

Don’t stop treatment with Xpovio without talking with your doctor first.

The Food and Drug Administration (FDA) approves prescription drugs such as Xpovio to treat certain conditions. Xpovio may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.

Xpovio for multiple myeloma

Xpovio is approved to treat multiple myeloma in people whose MM meets the following criteria:

  • Multiple myeloma (MM) in adults who have already tried at least one treatment for their condition. For this use, Xpovio is taken in combination with bortezomib (Velcade) and dexamethasone (Decadron).
  • Relapsed or refractory* multiple myeloma (RRMM) in adults who have already tried at least four treatments for their condition. These treatments must include drugs from specific classes that the cancer didn’t respond to. These include at least two proteasome inhibitors, two immunomodulatory agents, and one anti-CD38 monoclonal antibody.‡ For this use, Xpovio is taken in combination with dexamethasone.

* “Relapsed” means the cancer has come back after remission (a period of time when no cancer was detected). “Refractory” means the cancer didn’t respond (shrink or go away) to a previous treatment.
† For this use, Xpovio received accelerated approval by the Food and Drug Administration (FDA). See “FDA approval” in the “What is Xpovio?” section above for more details.
‡ A class of drugs is a group of medications that work in a similar way. Some MM treatments may contain more than one drug, so they may belong to more than one of these classes. For more information about these drug classes, talk with your doctor.

About multiple myeloma

MM is cancer that affects plasma cells, which are a type of white blood cell. As a part of the immune system, these cells help your body fight off infections.

Plasma cells are produced in bone marrow, a spongy tissue inside some of your bones. With MM, bone marrow produces too many plasma cells. As these cells multiply, tumors can form, and cancerous cells can spread into the body. Your bones may weaken over time as the cancerous cells build up in your bone marrow.

Effectiveness for multiple myeloma

Xpovio has been shown to be effective for treating MM and RRMM. Selinexor, the active drug in Xpovio, is recommended as a treatment option in the National Comprehensive Cancer Network.

For information about Xpovio’s effectiveness for MM and RRMM in clinical trials, see the drug manufacturer’s website or the drug’s prescribing information.

Xpovio for diffuse large B cell lymphoma

In addition to MM, Xpovio is also approved to treat diffuse large B cell lymphoma (DLBCL) that’s relapsed or refractory* in adults who have already tried at least two treatments for their condition.

* “Relapsed” means the cancer has come back after remission (a period of time when no cancer was detected). “Refractory” means the cancer didn’t respond (shrink or go away) to a previous treatment.
† For this use, Xpovio received accelerated approval by the Food and Drug Administration (FDA). See “FDA approval” in the “What is Xpovio?” section above for more details.

About diffuse large B-cell lymphoma

DLBCL is a cancer that affects your B cells. B cells are immune system cells that help defend your body against infection. They travel through a part of the immune system called the lymphatic system.

This system consists of a network of lymph nodes through which lymph fluid circulates. Lymph fluid helps transport bacteria and other germs out of your body.

With DLBCL, tumors can grow in your lymph nodes as B cells multiply.

Effectiveness for diffuse large B cell lymphoma

Xpovio has been shown to be effective for treating DLBCL. Selinexor, the active drug in Xpovio, is recommended as a treatment option in the National Comprehensive Cancer Network treatment guidelines.

For information about Xpovio’s effectiveness for DLBCL in a clinical trial, see the drug manufacturer’s website or the prescribing information.

Xpovio and children

Xpovio hasn’t been studied in children. Its safety in children is unknown.

For treating multiple myeloma (MM) and relapsed or refractory* multiple myeloma (RRMM), Xpovio is meant to be used with other drugs. These other drugs help to kill cancer cells in your body. They include:

If you have MM or RRMM, your doctor will prescribe the combination of drugs that’s likely to be most effective for your condition.

Regardless of the condition you’re using Xpovio to treat, your doctor will prescribe antinausea medications. You’ll take these to prevent or treat nausea and vomiting that often occurs with Xpovio. Examples include:

  • ondansetron (Zofran)
  • granisetron (Kytril)
  • rolapitant (Varubi)
  • promethazine (Phenergan)
  • olanzapine (Zyprexa)

If you have questions about other drugs prescribed for you to take with Xpovio, talk with your doctor or pharmacist.

* “Relapsed” means the cancer has come back after remission (a period of time when no cancer was detected). “Refractory” means the cancer didn’t respond (shrink or go away) to a previous treatment.

No harmful interactions are known to happen from drinking alcohol while taking Xpovio.

However, drinking too much alcohol can possibly worsen certain side effects of Xpovio, such as:

If you have questions about drinking alcohol during Xpovio treatment, talk with your doctor.

Drug interaction studies haven’t been done with Xpovio. But it’s likely that this drug can interact with several other medications. This is because of the way Xpovio is metabolized (broken down) in your body.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Xpovio and other medications

Below is a list of medications that can interact with Xpovio. This list does not contain all drugs that may interact with Xpovio.

Before taking Xpovio, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Types of drugs that may interact with Xpovio include:

  • CYP3A4 inhibitors. Xpovio is metabolized by an enzyme known as CYP3A4. Drugs that inhibit (block) the activity of this enzyme may increase the risk of side effects from Xpovio. Examples of CYP3A4 inhibitor drugs include:
    • certain antifungal medications, such as ketoconazole (Nizoral) and voriconazole (Vfend)
    • certain antiviral medications, such as ritonavir (Norvir) and boceprevir (Victrelis)
  • CYP3A4 inducers. Other drugs induce (speed up) the activity of the CYP3A4 enzyme. These drugs can make Xpovio less effective. Examples of CYP3A4 inducer drugs include:
    • certain seizure medications, such as carbamazepine (Tegretol) or phenytoin (Dilantin)
    • rifampin (Rifadin), an antibiotic

Xpovio and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Xpovio.

However, many herbs and supplements can interact with Xpovio because of the way the drug is metabolized (broken down) in your body. An example is the herbal remedy St. John’s wort, which is thought to help ease depression.

You should always check with your doctor or pharmacist before using any herbal or supplemental products while taking Xpovio.

Xpovio and foods

There aren’t any foods that have been specifically reported to interact with Xpovio. But it’s possible that grapefruit and grapefruit juice could interact with Xpovio.

Grapefruit blocks a specific enzyme known as CYP3A4 that metabolizes (breaks down) many types of drugs, including Xpovio. This could lead to increased levels of Xpovio in your body, which raises your risk for serious side effects.

Also, it may be best to eat bland foods until you see how Xpovio affects you. Nausea, vomiting, and other digestive side effects are common with this drug. A bland diet may help reduce nausea.

If you have any questions about eating certain foods with Xpovio, talk with your doctor.

You should take Xpovio according to your doctor’s or healthcare provider’s instructions.

The usual dosage schedule of Xpovio for MM is one dose per week.

The usual dosage of Xpovio for RRMM or DLBCL is two doses per week, on day 1 and day 3 of each week. For example, your dosing schedule for Xpovio may be every Sunday and Tuesday.

You can take Xpovio tablets with water. Be sure to swallow them whole.

Xpovio tablets are available in one strength: 20 milligrams (mg). You’ll likely be prescribed a dosage that requires you to take multiple tablets. Swallow them together (or one right after the other) on your scheduled days to take your dose. You shouldn’t take Xpovio tablets spaced throughout the day.

When to take

Take your Xpovio dose around the same time on the days you’re due to take it. For example, you could take Xpovio around 9 a.m. for your scheduled days. Sticking with the same time on the same days keeps the drug levels more consistent in your body.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alert on your phone, noting it on a calendar, or using a reminder app.

Taking Xpovio with food

You can take Xpovio tablets with or without food.

Can Xpovio be crushed, split, or chewed?

No, you shouldn’t crush, split, or chew Xpovio tablets. You should swallow them whole.

Xpovio may not be safe to take during pregnancy.

Xpovio hasn’t been studied in pregnant females.* Animal studies have shown harmful effects may occur to the fetus when a pregnant animal received the drug. However, animal studies don’t always predict what will happen with humans.

If you can become pregnant, your doctor will test you for pregnancy before giving you Xpovio. If you become pregnant while taking this drug, call your doctor right away.

* Sex and gender exist on spectrums. Use of the term “female” within this article refers to a person’s sex assigned at birth.

Xpovio and fertility

Xpovio may reduce your fertility (ability to conceive a child). In animal studies, both males and females had decreased fertility after receiving Xpovio.

Xpovio may not be safe to take during pregnancy. Animal studies have shown harmful effects may occur to the fetus when a pregnant animal receives the drug.

If you’re sexually active and you or your partner can become pregnant, you should use birth control during treatment with Xpovio. Continue using birth control for at least 1 week after your last dose of Xpovio.

Talk with your doctor about effective birth control options while you’re using Xpovio.

For more information about taking Xpovio during pregnancy, see the “Xpovio and pregnancy” section above.

It’s not safe to breastfeed during treatment with Xpovio. The drug hasn’t been tested in people who were breastfeeding. This is due to the risks of harmful effects that could happen to a child if the drug passes into breastmilk.

If you stop taking Xpovio, you shouldn’t breastfeed your child for at least 1 week after your final dose of the drug.

Talk with your doctor if you have questions about feeding your child during Xpovio treatment.

Here are answers to some frequently asked questions about Xpovio.

Is Xpovio chemotherapy?

Xpovio isn’t a chemotherapy drug. However, it’s used to treat certain cancers, specifically multiple myeloma (MM) and diffuse large cell B lymphoma (DLCBL).*

With cancer, certain cells in your body grow in an uncontrolled way. Chemotherapy drugs work to treat cancer by stopping cells from multiplying. However, these drugs may also affect healthy cells, which often leads to undesirable side effects.

Xpovio is a type of cancer treatment called targeted therapy. This type of treatment works by seeking out cells with specific targets, such as certain proteins, and attaching to them.

Xpovio targets cells that contain a protein known as XPO1. Some cancers have high levels of this protein. Once Xpovio attaches to its target, the drug inhibits (blocks) the XPO1 protein from functioning. This eventually kills the cancer cells.

To learn more about how Xpovio works to treat certain cancers, see the manufacturer’s website.

* Certain factors need to be considered before Xpovio can be used to treat these cancers. For more information, see the “Xpovio uses” section above.

Will my doctor monitor any aspects of my health during my Xpovio treatment?

Yes, your doctor will monitor various aspects of your health while you’re taking Xpovio to help prevent certain side effects.

Before starting Xpovio and regularly during treatment, you’ll need to have blood tests done. Your doctor may use these to check for low blood cell counts* and hyponatremia (low sodium level).

You’ll also need to monitor your weight while you’re taking Xpovio. Weight loss is often a side effect of Xpovio. This is related to the drug’s digestive side effects, such as nausea and vomiting.

If you’re able to become pregnant, your doctor will test your blood, urine, or both to check whether you’re pregnant. This is because Xpovio may not be safe to take during pregnancy.†

* For more about low blood cell counts, see the “Side effect details” section.
† For more about taking Xpovio during pregnancy, see the “Xpovio and pregnancy” section above.

Why did my doctor prescribe antinausea medication with Xpovio?

Digestive side effects are some of Xpovio’s most common side effects. Nausea and vomiting from taking Xpovio can become severe. To help reduce these side effects, your doctor will prescribe medications that help prevent nausea and vomiting.

Preventive medications may not control your nausea and vomiting. In this case, your doctor will prescribe other or stronger medications to treat episodes of severe nausea and vomiting.

These medications often come in forms that you don’t have to take by mouth. Examples include injections, skin patches, and tablets that dissolve under your tongue.

Before taking Xpovio, talk with your doctor about your health history. Xpovio may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Recent or active infection. Xpovio can affect your body’s immune system. Because of this, you may not be able to fight off infections. It’s important to tell your doctor about any recent or current infections. This includes minor or suspected ones, such as a possibly infected wound on your skin. Your doctor will likely treat you for your infection or wait until it’s gone before having you start Xpovio.
  • Bleeding problems. Xpovio can lower your body’s ability to stop bleeding. If you already have a condition that causes you to bleed or bruise more easily, this drug may not be safe for you. Talk with your doctor about the benefits and risks of Xpovio treatment.
  • Allergic reaction. If you’ve had an allergic reaction to Xpovio or any of its ingredients, you shouldn’t take Xpovio. Ask your doctor which other medications are better options for you.
  • Pregnancy. It’s not safe to take Xpovio while pregnant. You should use birth control during Xpovio treatment and for at least 1 week after your last dose. For more information, see the “Xpovio and pregnancy” section above.
  • Breastfeeding. Taking Xpovio while breastfeeding could seriously harm your child. Don’t breastfeed your child during Xpovio treatment or for at least 1 week after your last dose. For more information, see the “Xpovio and breastfeeding” section above.

Note: For more information about the potential negative effects of Xpovio, see the “Xpovio side effects” section above.

Do not use more Xpovio than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Xpovio

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Xpovio from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Xpovio tablets at a room temperature of up to 86°F (30°C) in a tightly sealed container. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Xpovio and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.