Copanlisib (Aliqopa®)

Author: Karen Arnold-Korzeniowski, BSN RN
Content Contributor: Christina Bach, MBE, LCSW, OSW-C
Last Reviewed: April 20, 2026

Pronounce: koe-pan-LIS-ib

Classification: Kinase Inhibitor

About Copanlisib (Aliqopa®)

A kinase is an enzyme that helps a cell grow. There are different types of kinases. Each type affects a different phase of cell growth. Kinase inhibitors slow down the growth of cancer cells. 

How to Take Copanlisib

Copanlisib is given by intravenous (IV, into a vein) infusion. Your dose and how often you receive the medication will be decided by your providers.

The blood levels of this medication can be affected by certain foods and medications, so they should be avoided. These include: grapefruit, grapefruit juice, voriconazole, ketoconazole, rifampin, phenytoin, St. John’s wort, and diltiazem, among others. Be sure to tell your provider about all medications and supplements you take. Your dose of copanlisib may be reduced if you are taking certain other medications.

Tell your provider if you have a history of cytomegalovirus (CMV). 

Possible Side Effects

These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.

Infection and Low White Blood Cell Count (Leukopenia or Neutropenia)

This medication can cause serious infections, with or without a decrease in white blood cell counts.

White blood cells (WBC) help your body fight infection. While you are having cancer treatment, your WBC count can drop, putting you at a higher risk of an infection. Tell your provider right away if you have a fever (a temperature greater than 100.4°F or 38°C), sore throat or cold, shortness of breath, cough, burning with urination, or a sore that doesn't heal.

Tips for preventing infection:

  • Hand washing,  both yours and your visitors, is the best way to prevent the spread of infection.
  • Avoid large crowds and people who are sick (those who have a cold, fever, or cough, or if someone you live with has these symptoms).
  • When working outside, wear clothes that protect you, like long pants and gloves.
  • Do not handle pet waste.
  • Keep all cuts and scratches clean.
  • Shower or bathe daily.
  • Brush your teeth at least twice a day.
  • Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
  • Ask your providers before scheduling dental appointments or procedures.

Ask your providers before you or someone you live with has any vaccines

Low Red Blood Cell Count (Anemia)

Anemia is when your red blood cell count is lower than normal. Red blood cells carry oxygen to the tissues in your body. When your red cell count is low, you may feel tired or weak. Tell your providers if you have shortness of breath, trouble breathing, or pain in your chest. If your count gets too low, you may receive a blood transfusion.

Low Platelet Count (Thrombocytopenia)

Platelets are blood cells that help your blood clot. Thrombocytopenia is when your platelet count is lower than normal, and you are at a higher risk of bleeding. Tell your providers if you have any bruising or bleeding, including nose bleeds, bleeding gums, or blood in your urine or stool. If your count gets too low, you may receive platelets from a donor. 

  • Do not use a razor (an electric razor is fine).
  • Do not do activities that can cause injury or bleeding.
  • Talk to your provider before taking any non-steroidal, anti-inflammatory medications (NSAIDs) like Motrin/Advil (ibuprofen), Aleve (naproxen), Celebrex (celecoxib), and others. These can raise the risk of bleeding. 
  • Use a soft-bristle toothbrush to brush your teeth. Ask your provider about flossing or using toothpicks. 

High Blood Sugar

This medication can cause high blood sugar in patients with and without diabetes. Symptoms can be:

  • Feeling more thirsty.
  • More frequent urination.
  • Feeling hungrier. 
  • Blurry vision.
  • Headaches.
  • Breath smelling like fruit.

All patients will have their blood sugar checked with blood tests. If you have diabetes and your blood sugars are higher than normal, talk to your provider. Tell your provider if you have any of these symptoms.

High Blood Pressure

This medication can cause high blood pressure (hypertension). You should have your blood pressure checked often during therapy, so that if you have high blood pressure, it can be treated. If your blood pressure cannot be controlled, your provider may want you to stop taking the medication. Tell your providers about any headaches, vision changes, or dizziness. 

Diarrhea

Diarrhea is when you pass three or more stools in a day. Your providers can suggest medications to relieve diarrhea. Do not take any medications to manage your diarrhea without talking to your provider first, as your stool may need to be tested. To manage it, try eating foods that are low in fiber and bland, like white rice and boiled or baked chicken. Try not to eat raw fruits, vegetables, whole grain breads, cereals, and seeds. Soluble fiber is a type of fiber found in some foods that helps absorb (soak up) fluid. Foods high in soluble fiber are applesauce, bananas (ripe), canned fruit, oranges, boiled potatoes, white rice, foods made with white flour, oatmeal, cream of rice, cream of wheat, and farina. Stay hydrated by drinking 8 to 10 glasses of non-alcoholic, non-caffeinated fluid each day.

Fatigue

Fatigue can cause exhaustion, feeling worn out and that your body is "heavy" and hard to move, or being unable to focus. It is common when you have cancer, and it is not the same as feeling tired. You may need to adjust your schedule to manage fatigue. Plan times to rest during the day and save your energy for more important activities. Exercise can help lessen fatigue. Talk to your providers about ways to deal with this side effect.

Nausea and/or Vomiting

Talk to your providers if you have nausea and/or vomiting. They can prescribe medications to help you. Making changes to your diet can also help. Avoid things that make your symptoms worse, like heavy or greasy/fatty foods and spicy or acidic foods, like tomatoes, lemons, and oranges. Try saltines or ginger ale to help your symptoms.  

Call your providers if you cannot keep fluids down for more than 12 hours or if you feel lightheaded or dizzy.

Fertility

This medication may affect your fertility. It can cause changes to your menstrual cycle or sperm. You may want to consider sperm banking or egg harvesting if you might wish to have a child in the future. Talk about your options with your provider before treatment.

Reproductive Concerns

There is a higher risk of health problems for your baby if you are pregnant, become pregnant, or get someone pregnant while on this medication. To lower the risk of birth defects, you should use birth control (contraception) to avoid pregnancy. Talk with your provider about what kind of birth control is safest for you and your partner.

If you can become pregnant, you will need to use effective birth control during treatment and for 1 month after the last dose of this medication, even if your menstrual cycle has stopped or changed. If you can get someone pregnant, you will need to use effective birth control during treatment and for 1 month after the last dose of this medication, even if you believe you are not producing sperm. You should not breastfeed during treatment and for 1 month after the last dose of this medication.

Important but Less Common Side Effects

Skin Reactions

You may develop a rash, skin peeling, and itching. This can be a serious side effect. Contact your provider for any changes in your skin. Your dose may be held, decreased, or the medication may be stopped completely for severe skin reactions.

Pneumonitis

Pneumonitis is inflammation of the lungs. Tell your provider right away if you get any new or worsening symptoms, like:

  • Shortness of breath.
  • Trouble breathing.
  • A cough.
  • Fever.