Xpovio (selinexor) is a brand-name oral tablet that’s prescribed to treat multiple myeloma in some adults. As with other drugs, Xpovio can cause side effects, such as fatigue, nausea, and diarrhea.

Xpovio can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Xpovio in clinical trials:

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

Mild side effects can occur with Xpovio use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Xpovio’s prescribing information.

Mild side effects that have been reported with Xpovio include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Xpovio and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after using Xpovio. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Xpovio may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Xpovio’s prescribing information.

If you develop serious side effects while taking Xpovio, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • Hyponatremia (low sodium level in the blood). Symptoms can include:
    • confusion
    • sleepiness
    • fatigue
  • Neutropenia (low level of white blood cells). Symptoms can include:
    • fever
    • sore throat
    • flu-like symptoms
    • cough
  • Anemia (low level of red blood cells). Symptoms can include:
    • fatigue
    • fast heartbeat
    • shortness of breath
    • pale skin
  • Serious infections, such as upper respiratory tract infections or pneumonia. Symptoms can include:
    • chills or sweating
    • fever
    • coughing
  • Cataracts (clouding of the lens in your eye). Symptoms can include:
    • sensitivity to light
    • changes in vision, such as blurred or double vision
  • Neurological problems (related to the brain). Symptoms can include:
  • High fever.
  • Changes in kidney and liver function tests.
  • Severe digestive side effects.*
  • Thrombocytopenia (low platelet levels in the blood).*
  • Severe allergic reaction.†

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after using Xpovio. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Learn more about some of the side effects that Xpovio may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Xpovio.

Digestive side effects

Digestive side effects were commonly reported in clinical studies of Xpovio. In some people, these side effects can be severe. Digestive side effects may include:

  • nausea or vomiting
  • diarrhea
  • constipation
  • decreased appetite

Severe digestive side effects may lead to additional problems or side effects. These include dehydration, weight loss, and low blood sodium levels.

What you can do

Your doctor will likely prescribe medications to take before and during treatment with Xpovio to help reduce side effects.

Nausea and vomiting may affect your ability to eat and drink well, increasing your risk of dehydration. Your doctor may prescribe you medication, such as ondansetron (Zofran), to reduce nausea and vomiting.

If diarrhea is severe, you may lose too much body fluid and may be at increased risk for dehydration. Your doctor will prescribe a medication to help prevent diarrhea, such as loperamide.

Loss of appetite is also common and can sometimes be severe. Your doctor will monitor your appetite and weight during treatment and may recommend additional ways to help increase your appetite or other nutritional support.

Talk with your doctor if your digestive side effects aren’t relieved with treatment or become severe. They may recommend different treatments to try. They also may have you take a lower dosage of Xpovio. In some cases, they may have you temporarily or permanently stop taking the drug.

Low platelet count

Xpovio can cause a low platelet count, also known as thrombocytopenia. This is a common side effect in clinical trials of the drug. Platelets in your blood help your blood to clot and stop bleeding if there is an injury. Low platelet counts typically don’t cause a problem. However, some people may have a severely low platelet count while taking Xpovio, which can cause symptoms such as:

What you can do

Your doctor will monitor your platelet count during treatment with Xpovio. They’ll order a blood test known as a complete blood test (CBC) to measure levels of different blood cell types, including platelets. They’ll check your platelet levels before you start taking Xpovio. They’ll also recheck your levels frequently during the first 3 months of treatment.

If your doctor finds that you have a low platelet count, they will treat you based on how low your levels are. This may include a blood transfusion or other treatments. Also, be sure to tell your doctor if you have any symptoms of thrombocytopenia, such as bleeding gums. Your doctor may prescribe a lower dosage of Xpovio. In some cases, they may have you temporarily or permanently stop taking the drug.

Allergic reaction

As with most drugs, Xpovio can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Xpovio. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you take Xpovio. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These include:

Bleeding problems: If you have a condition that causes you to bruise or bleed easily, Xpovio may not be safe for you. This is because Xpovio can lower your body’s ability to stop bleeding and could worsen your condition. Talk with your doctor about whether treatment with Xpovio is right for you.

Infection: Treatment with Xpovio can weaken your immune system, which makes it harder for your body to fight off infections. Before starting treatment with Xpovio, tell your doctor if you’ve had a recent infection or have an active infection. This includes any suspected or minor infections, such as a skin rash. Your doctor will likely want to treat your infection before starting treatment with Xpovio.

Allergic reaction: If you’ve had an allergic reaction to Xpovio or any of its ingredients, your doctor will likely not prescribe Xpovio. Ask your doctor what other medications may be better options for you.

Pregnancy or breastfeeding: If you’re pregnant or breastfeeding your child, Xpovio may not be safe for you to take. Talk with your doctor if you’re pregnant, planning to become pregnant, or breastfeeding. They can recommend a different treatment option for you.

Alcohol consumption: If you drink alcohol, Xpovio is likely safe for you. However, drinking too much alcohol could worsen some side effects of Xpovio, such as nausea or diarrhea. Talk with your doctor about how much alcohol is safe for you to take during treatment with Xpovio.

Xpovio can cause mild and serious side effects. Some side effects may be severe and require treatment. Talk with your doctor if you develop side effects that are bothersome or serious.

If you’d like to learn more about Xpovio, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Xpovio: For details about other aspects of Xpovio, refer to this article.
  • A look at your condition: For details about multiple myeloma, see our cancer hub.

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 another 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.