Drug Interaction Report

Idelalisib can increase the blood levels of copanlisib. This may increase side effects such as nausea, vomiting, diarrhea, mouth sores, high blood sugar, high blood pressure, lung or breathing problems, severe skin reactions, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Grapefruit juice can increase the blood levels of copanlisib. This may increase side effects such as nausea, vomiting, diarrhea, mouth sores, high blood sugar, high blood pressure, lung or breathing problems, severe skin reactions, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should avoid the consumption of grapefruit and grapefruit juice during treatment with copanlisib. Talk to your doctor or pharmacist if you have questions on this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

The recommended maximum number of medicines in the 'PI3K inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'PI3K inhibitors' category:

• copanlisib
• idelalisib

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.