| Multiple Myeloma
Ninlaro vs Xpovio
Side-by-side clinical, coverage, and cost comparison for multiple myeloma.Deep comparison between: Ninlaro vs Xpovio with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXpovio has a higher rate of injection site reactions vs Ninlaro based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xpovio but not Ninlaro, including UnitedHealthcare
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Category
Ninlaro
Xpovio
At A Glance
Oral
Once weekly (Days 1, 8, 15 of 28-day cycle)
Proteasome inhibitor
Oral
Once or twice weekly
XPO1 inhibitor
Indications
- Multiple Myeloma
- Multiple Myeloma
- Diffuse Large B-Cell Lymphoma
Dosing
Multiple Myeloma 4 mg orally once weekly on Days 1, 8, and 15 of a 28-day cycle in combination with lenalidomide 25 mg daily (Days 1-21) and dexamethasone 40 mg (Days 1, 8, 15, 22); reduce starting dose to 3 mg for moderate or severe hepatic impairment, severe renal impairment (CrCl <30 mL/min), or ESRD requiring dialysis.
Multiple Myeloma (with Bortezomib and Dexamethasone) 100 mg orally once weekly on Day 1 of each week in combination with bortezomib 1.3 mg/m2 SC once weekly and dexamethasone 20 mg orally twice weekly on Days 1 and 2.
Multiple Myeloma (with Dexamethasone) 80 mg orally on Days 1 and 3 of each week in combination with dexamethasone 20 mg orally on Days 1 and 3 of each week.
Diffuse Large B-Cell Lymphoma 60 mg orally on Days 1 and 3 of each week until disease progression or unacceptable toxicity.
Contraindications
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Adverse Reactions
Most common (>=20%) Thrombocytopenia, neutropenia, diarrhea, constipation, peripheral neuropathy, nausea, peripheral edema, rash, vomiting, bronchitis
Serious Diarrhea, thrombocytopenia, bronchitis
Postmarketing Angioedema, toxic epidermal necrolysis
Most common (>=20%) Fatigue, nausea, thrombocytopenia, decreased appetite, diarrhea, vomiting, weight decreased, anemia, peripheral neuropathy, upper respiratory tract infection, hyponatremia, cataract
Serious Thrombocytopenia, neutropenia, gastrointestinal toxicity (nausea, vomiting, diarrhea, weight loss), hyponatremia, serious infection (including pneumonia and sepsis), neurological toxicity, cataract
Pharmacology
Ixazomib is a reversible proteasome inhibitor that preferentially binds and inhibits the chymotrypsin-like activity of the beta 5 subunit of the 20S proteasome, inducing apoptosis in multiple myeloma cell lines and demonstrating synergistic cytotoxic effects in combination with lenalidomide.
Selinexor reversibly inhibits exportin 1 (XPO1), blocking nuclear export of tumor suppressor proteins and oncogenic mRNAs, causing nuclear accumulation of tumor suppressors, downregulation of oncoproteins such as c-myc and cyclin D1, cell cycle arrest, and apoptosis of cancer cells.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Ninlaro
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
Xpovio
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Ninlaro
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Xpovio
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Ninlaro
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Xpovio
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableCancerCare: Multiple Myeloma
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$5/momo
Xpovio Co-Pay CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.