Indications
Selinexor is an anticancer medicine used, usually together with Dexamethasone and sometimes with Bortezomib, to treat multiple myeloma (a cancer of plasma cells in the bone marrow) that has come back or not responded to earlier treatments. It is also used for certain types of diffuse large B-cell lymphoma that have relapsed after other therapies.
How It Works
Cells contain proteins that help stop cancer growth (tumour suppressor proteins). A transporter called XPO1 (exportin 1) moves many of these proteins out of the cell’s nucleus, where they cannot do their job. Selinexor blocks XPO1, so these proteins stay inside the nucleus, which leads to the death of cancer cells.
Dosage and Administration
Selinexor is prescribed and supervised by a cancer specialist. Take it exactly as prescribed, usually on set days of each week together with other medicines; the dose depends on the treatment plan and may be lowered if side effects occur. Swallow the tablets whole with water; do not crush, chew or split them. Your doctor will usually give anti-sickness medicine before and during treatment. Regular blood tests check blood counts, sodium levels and weight.
Interactions
- Other medicines that cause drowsiness or confusion, such as sedatives and strong painkillers: may increase dizziness and confusion.
- Paracetamol in high doses: use only as advised.
- Medicines that lower blood counts or sodium levels may add to these effects.
Tell your cancer team about every medicine, herbal product and supplement you take.
Contraindications
Do not take Selinexor if you are allergic to it or any ingredient, if you are pregnant, or if you are breastfeeding.
Side Effects
Very common side effects include nausea, vomiting, loss of appetite, weight loss, diarrhoea, tiredness, low platelets (which can cause bleeding), low white cells and red cells, low sodium in the blood, blurred vision, dizziness and confusion. Infections are more likely.
Get urgent medical help if you have fever or other signs of infection, bleeding that does not stop, blood in vomit, urine or stools, severe or ongoing vomiting or diarrhoea, inability to eat or drink, fainting, new confusion or sleepiness, or sudden changes in vision.
Pregnancy and Lactation
Selinexor can harm an unborn baby. Women who can become pregnant and men with female partners must use effective contraception during treatment and for at least 1 week after the last dose, or as advised by the doctor. Do not breastfeed during treatment and for 1 week after the last dose.
Precautions and Warnings
Drink enough fluids and eat enough calories to prevent dehydration and weight loss. Do not drive or operate machinery if you feel dizzy, confused or have blurred vision. Avoid situations that may cause falls. Tell your doctor about any eye problems; cataracts may develop or worsen. Keep all blood test appointments.
Overdose
An overdose may cause severe nausea, vomiting, diarrhoea, dehydration, confusion and low sodium. Seek medical help straight away and take the pack with you.
Therapeutic Class
Anticancer agent, selective inhibitor of nuclear export (XPO1 inhibitor).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Handle tablets with care and wash your hands after touching them.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.