Selinexor (oral route)

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. If you are a woman who can bear children, your doctor may give you a pregnancy test before you start using this medicine to make sure you are not pregnant. Female patients should use effective birth control during treatment and for at least 1 week after the last dose. Male patients who have female partners should use effective birth control during treatment and for at least 1 week after the last dose. If you think you have become pregnant while using this medicine, tell your doctor right away.

Selinexor can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

• If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
• Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in urine or stools, or pinpoint red spots on your skin.
• Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
• Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
• Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
• Avoid contact sports or other situations where bruising or injury could occur.

Nausea, vomiting, diarrhea, loss of appetite, or weight loss may occur with selinexor, which can be severe and cause dehydration. Your doctor may give you medicine or other treatments for these. Check with your doctor right away if you notice that you are losing weight or have a decrease in appetite.

This medicine may make you dizzy or confused. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Tell your doctor if you are using other medicine that cause dizziness or mental changes.

This medicine may cause hyponatremia (low sodium levels in the blood). Check with your doctor right away if you have loss of consciousness, confusion, seizures, decreased urine output dizziness, fast or irregular heartbeat, muscle pain or cramps, trouble breathing, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

This medicine may cause serious infections. Check with your doctor right away if you have chest pain, fever or chills, confusion, cough or hoarseness, dizziness, fainting, fast heartbeat, lightheadedness, lower back or side pain, painful or difficult urination, sneezing, sore throat, tightness in the chest, or trouble breathing.

This medicine may cause brain or nerve problems. Check with your doctor right away if you have blurred or double vision, confusion as to time, place, or person, difficulty in walking, dizziness, drooping eyelids, fainting, hallucinations, headache, holding false beliefs that cannot be changed by fact, jaw pain, loss of memory, numbness or tingling in the fingers and toes, pain in the fingers and toes, pain in the testicles, problems with memory, unusual excitement, nervousness, or restlessness, or weakness.

This medicine may cause eye problems (eg, cataracts). Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

This medicine could cause infertility in some men and women. Talk with your doctor before using this medicine if you plan to have children.