What the label lists and what reports show
Selinexor side effects
Selinexor's FDA label: “The most common adverse reactions (≥20%) in patients with multiple myeloma who receive XVd are fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, weight decreased, cataract, and vomiting.” FAERS holds 8,606 reports naming it through July 30, 2026; the reaction reported most often, leaving out the conditions it is used for, product-use terms and outcomes, is nausea (2,622 reports).
- No generic listed
Check it at the source: the selinexor FDA label on DailyMed (effective May 12, 2026, Karyopharm Therapeutics Inc.); the FDA FAERS public dashboard.
What does the patient leaflet say about side effects?
From the patient leaflet: What are the possible side effects of XPOVIO?XPOVIO can cause serious side effects, including: See “What is the most important information I should know about XPOVIO?” Stomach and intestinal (gastrointestinal) problems are common with XPOVIO and can sometimes be severe. Nausea and vomiting. Nausea and vomiting may affect your ability to eat and drink well. You can lose too much body fluid and body salts (electrolytes) and may be at risk for becoming dehydrated. You may need to receive intravenous (IV) fluids or other treatments to help prevent dehydration. Your healthcare provider will prescribe anti-nausea medicines for you to take before you start and during treatment with XPOVIO. See “How should I take XPOVIO?” Diarrhea. You can lose too much body fluid and body salts (electrolytes) and may be at risk for becoming dehydrated. You may need to receive IV fluids or other treatments to help prevent dehydration. […]
Source: FDA drug label, Karyopharm Therapeutics Inc., effective May 12, 2026 (SPL set f6dd2682-75a6-4863-90a8-a3197f6f78a8), via openFDA; the full label on DailyMed
What does the label list?
From the label: adverse reactionsThe most common adverse reactions (≥20%) in patients with multiple myeloma who receive XVd are fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, weight decreased, cataract, and vomiting.
Table 8: Adverse Reactions (≥10%) in Patients Who Received XPOVIO in STORM
| Reaction | Adverse Reaction All Grades (%) | XPOVIO 80 mg twice weekly + Dexamethasone (n=202) Grades ≥3 (%) |
|---|---|---|
| Thrombocytopenia a | 74 | 61 |
| Fatigue b | 73 | 22 |
| Nausea | 72 | 9 |
| Anemia c | 59 | 40 |
| Decreased appetite | 53 | 4.5 |
| Weight decreased | 47 | 0.5 |
| Diarrhea | 44 | 6 |
| Vomiting | 41 | 3.5 |
| Hyponatremia | 39 | 22 |
| Neutropenia d | 34 | 21 |
| Leukopenia | 28 | 11 |
| Constipation | 25 | 1.5 |
| Dyspnea e | 24 | 3.5 k |
| Upper respiratory tract infection f | 21 | 3 |
| Cough g | 16 | 0 |
| Mental status changes h | 16 | 7 |
| Pyrexia | 16 | 0.5 |
| Hyperglycemia | 15 | 7 |
| Dizziness | 15 | 0 |
| Insomnia | 15 | 2 |
| Lymphopenia | 15 | 10 |
| Dehydration | 14 | 3.5 |
| Hypercreatininemia i | 14 | 2 |
| Pneumonia j | 13 | 9 k |
| Epistaxis | 12 | 0.5 |
Rows and numbers as the label prints them, under its own column headings (the first rows of a longer table where it runs on). A reaction in a trial table is not necessarily caused by the medicine, and trials differ from everyday use.
From the label: adverse reactions, continuedThe following clinically significant adverse reactions are described in detail in other labeling sections: Thrombocytopenia [see Warnings and Precautions ( 5.1 )]. Neutropenia [see Warnings and Precautions ( 5.2 )]. Gastrointestinal Toxicity [see Warnings and Precautions ( 5.3 )]. Hyponatremia [see Warnings and Precautions ( 5.4 )]. Serious Infection [see Warnings and Precautions ( 5.5 )]. Neurological Toxicity [see Warnings and Precautions ( 5.6 )]. Cataract [see Warnings and Precautions ( 5.8 )]. The most common adverse reactions (≥20%) in patients with multiple myeloma who receive XVd are fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, weight decreased, cataract, and vomiting. Grade 3-4 laboratory abnormalities (≥10%) are thrombocytopenia, lymphopenia, hypophosphatemia, anemia, hyponatremia, and neutropenia ( 6.1 ). The most common adverse reactions (≥20%) in patients with multiple myeloma who receive Xd are thrombocytopenia, fatigue, nausea, anemia, decreased appetite, weight decreased, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea, and upper respiratory tract infection ( 6.1 ).
Source: FDA drug label, Karyopharm Therapeutics Inc., effective May 12, 2026 (SPL set f6dd2682-75a6-4863-90a8-a3197f6f78a8), via openFDA; the full label on DailyMed
What do FAERS reports show?
8,606 reports list selinexor among the medicines taken, each a report of something that happened, not proof the medicine caused it; 1,459 are coded as a death and 2,642 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is. Of the 21 reactions below, 18 are named by the same term (in US spelling) in the label's adverse reactions, warnings or patient leaflet; a reaction the label does not name may still be there under another word, and a report does not show that the medicine caused it.
Reports received each year
The 25 most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026; reactions as MedDRA preferred terms
What next?
- Selinexor: the full record
- label, generics, price, shortages, recalls
- Report a side effect to the FDA
- MedWatch
- Side effects hub
- the most reported medicines and reactions