Duvelisib: what it treats, how to take it, side effects
Last updated September 7, 2026.
**Duvelisib, sold as Copiktra, is a prescription cancer medicine in the PI3 kinase inhibitor class.** It blocks signals that help cancer cells grow and survive. Its boxed warning covers treatment-related deaths and potentially fatal infections, bowel inflammation, skin reactions, and lung inflammation.
What does it treat?
You may receive duvelisib for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) that returns or does not respond after at least two previous systemic treatments. These cancers affect white blood cells and lymph nodes. It is not recommended as your first or second treatment because of increased treatment-related mortality.
How do you take it?
Capsules contain 15 mg or 25 mg. Your usual adult dose is 25 mg twice daily, totaling 50 mg daily, with or without food. Swallow capsules whole. Do not exceed your prescription; a specific interaction can require a specialist to prescribe 40 mg twice daily. If less than 6 hours late, take your dose; if more than 6 hours late, skip it. At exactly 6 hours, ask your pharmacist. Never double doses. Hold treatment and call immediately for suspected infection, severe diarrhea, blistering rash, or new breathing symptoms.
Side effects to know
- Common: You may experience tiredness, nausea, muscle or bone pain, diarrhea, rash, infections, or low blood counts; report fever and new diarrhea promptly.
- Serious: Stop taking duvelisib and get urgent help for fever with chills, bloody diarrhea, severe abdominal pain, blistering or peeling skin, mouth sores, or new cough or shortness of breath. Yellow skin or eyes, dark urine, or unusual bleeding require immediate medical assessment for liver injury.
Who should not take it?
Before treatment, discuss allergies, active infections, previous cytomegalovirus infection, bowel inflammation, lung problems, and liver disease. Have your pharmacist check all medicines and supplements, especially St. John's wort and drugs affecting CYP3A4. Duvelisib can harm a fetus; discuss pregnancy immediately. Do not breastfeed during treatment or for at least 1 month afterward. Ask your oncology team before drinking alcohol.
When is it an emergency?
Call 911 for collapse, breathing trouble, or swelling of your tongue or throat. Go to an emergency department for widespread blistering, severe bloody diarrhea, or fever with confusion. For overdose, call Poison Control at 1-800-222-1222 immediately, even without symptoms, and contact your oncology team.
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Common questions
What is the maximum daily dose?
Your usual prescribed total is 50 mg daily. The label allows 80 mg daily only for a specific unavoidable interaction with a moderate CYP3A4 inducer. Your oncologist must direct that adjustment; never increase it yourself.
Can I drink alcohol?
The label gives no specific alcohol limit. Duvelisib can injure your liver. Ask your oncology team whether alcohol is appropriate for you before drinking.
What if I am pregnant or breastfeeding?
You need a pregnancy test before starting if you can become pregnant. Use effective contraception during treatment and for at least 1 month afterward, including if you are male with a partner who can become pregnant. Report pregnancy immediately. Avoid breastfeeding during treatment and for at least 1 month afterward.
Do I need to take it with food?
You can take it with or without food. Keep consistent dosing times. Swallow each capsule whole without opening, chewing, or breaking it.
What are the signs of an overdose?
The label does not identify a specific overdose symptom pattern. Do not wait for symptoms. Call Poison Control at 1-800-222-1222 immediately; call 911 for collapse or breathing trouble.
Which medicines interact, and do I need infection prevention?
Strong CYP3A4 inhibitors such as ketoconazole require a lower duvelisib dose. Avoid strong inducers such as rifampin and discuss St. John's wort with your pharmacist. Your team must prescribe prevention against Pneumocystis pneumonia during treatment and afterward until immune recovery. Antiviral prevention against cytomegalovirus may also be considered.