MedeliX
Start asking

selinexor

Nexpovio · ATC code L01XX66

Also known as: Selineksor

Key facts
Active substance
selinexor
ATC code
L01XX66
Authorisation
centrally authorised across the EU (EMA)
Dosage forms
NEXPOVIO 20 mg film-coated tablets
Marketing authorisation holder
Stemline Therapeutics B.V.
Information as of
2026-10-29

Key facts

Selinexor (Nexpovio) is an oral selective inhibitor of nuclear export (XPO1 inhibitor) used with dexamethasone, and in one regimen also bortezomib, to treat multiple myeloma.

What it is used for

  • Multiple myeloma in adults after at least one prior therapy, in combination with bortezomib and dexamethasone.
  • Multiple myeloma in adults after at least four prior therapies, refractory to at least two proteasome inhibitors, two immunomodulatory agents and an anti-CD38 antibody, with progression on the last therapy, in combination with dexamethasone.

Dosing

  • With bortezomib and dexamethasone (35-day cycle): selinexor 100 mg once weekly on Day 1 of each week (not exceeding 70 mg/m2 per dose); bortezomib 1.3 mg/m2 subcutaneously once weekly for 4 weeks then 1 week off; dexamethasone 20 mg twice weekly.
  • With dexamethasone: selinexor 80 mg on Days 1 and 3 of each week, each with dexamethasone 20 mg.
  • Prespecified dose reduction steps for adverse reactions (e.g. thrombocytopenia, neutropenia, hyponatraemia); see the full text.
  • A missed or vomited dose should not be repeated; take the next dose on the next scheduled day.
  • Continue until disease progression or unacceptable toxicity.

Contraindications

  • Hypersensitivity to the active substance or any excipient.

Important warnings

  • Prophylactic 5-HT3 antagonists and/or other anti-nausea agents should be given; adequate fluid and caloric intake.
  • Thrombocytopenia, sometimes severe with bleeding; neutropenia and infections: blood counts at baseline and frequently during the first two months.
  • Hyponatraemia: sodium should be checked regularly.
  • Neurological toxicity (e.g. dizziness, confusion): no driving or operating machinery until symptoms resolve.
  • New onset or worsening cataract; tumour lysis syndrome can occur.

Side effects

  • With bortezomib/dexamethasone, most frequent (≥30%): thrombocytopenia (62%), nausea (50%), fatigue (42%), anaemia (37%), decreased appetite (35%), diarrhoea (33%), peripheral neuropathy (33%).
  • With dexamethasone, most frequent: nausea (75%), thrombocytopenia (75%), fatigue (66%), anaemia (60%), decreased appetite (56%), decreased weight (49%), hyponatraemia (40%).
  • Most common serious reactions: pneumonia and sepsis.

Interactions

  • Carbamazepine (a strong CYP3A4 inducer) and clarithromycin (a strong CYP3A4 inhibitor) caused no clinically significant pharmacokinetic changes.
  • Other medicines that may cause dizziness or confusion should not be taken without medical advice.

Pregnancy and breastfeeding

  • Not recommended during pregnancy; women and men should use contraception for at least 1 week after the last dose; pregnancy test before starting.
  • Breast-feeding should be discontinued during treatment and for 1 week after the last dose.

Summary of the official product information, written with AI on 2026-10-29. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.

Full official text →

Common questions – ask Medelix

For patients

Package leaflet, verbatim

This product has no separate US patient information.

Authorisation and brand names by country

Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.

EU – centrally authorised (all member states)

  • NexpovioStemline Therapeutics B.V. · EMEA/H/C/005127

Source: European Medicines Agency (EMA), product information

Turkey

  • NexpovioMENARİNİ STEMLINE İLAÇ SAN. VE TİC. A.Ş. · 5 register entries

Source: TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, as of 2026-10-16

Brand names in 3 more European countries
Iceland
Nexpovio
Liechtenstein
Nexpovio
Norway
Nexpovio

EMA – Article 57 product data (EU/EEA), 2026-10-29

Medelix receives no money from pharmaceutical companies. Brand names are listed alphabetically and without ranking.

Other substances in the same group

Another question about this substance?

Medelix answers clinical questions from guidelines, studies and product information – every claim with its source.

Sources

  1. European Medicines Agency. Nexpovio – EPAR, Product Information. 2026-10-29. https://www.ema.europa.eu/en/documents/product-information/nexpovio-epar-product-information_en.pdf
  2. TİTCK – Ruhsatlı Beşeri Tıbbi Ürünler Listesi, 2026-10-16. https://www.titck.gov.tr/dinamikmodul/85

Editorial: Medelix editorial team · last updated 2026-10-29 · How these pages are made · Report an error

Source: European Medicines Agency (EMA), product information. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.