Cangrelor

Class
Antiplatelets
Subclass
P2Y12 inhibitors
Substance name
Cangrelor
Brand names
Kengreal®
Common formulations
Powder for parenteral solution
Dosage and administration
Adults patients
Prevention of periprocedural complications for PCI • For rapid and potent intravenous P2Y12 inhibition to reduce the occurrence of myocardial infarction, repeat coronary revascularization and stent thrombosis
•
Loading: 30 mcg/kg IV bolus
•
Maintenance: 4 mcg/kg/min IV continuous infusion for at least 2 hours or duration of procedure, whichever is longer
Indications for use
Labeled indications
Adults
•
Prevention of periprocedural complications for PCI (for rapid and potent intravenous P2Y12 inhibition to reduce the occurrence of myocardial infarction, repeat coronary revascularization and stent thrombosis)
Safety risks
Contraindications
Hypersensitivity to cangrelor or any of its components
Significant active bleeding
Warnings and precautions
Bleeding
•
Maintain a high level of suspicion, as bleeding events of all severities have been observed with the use of cangrelor.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required.
Renal replacement therapy
Any modality
•
Use acceptable. No dose adjustment required.
Hepatic impairment
Any severity
•
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals. Performance of neuraxial blockade procedures is not recommended during cangrelor use due to the potential risk of spinal hematoma.
•
When possible, discontinue the use of cangrelor 1 hour prior to labor, delivery, or neuraxial blockade.
•
Myocardial infarction is a medical emergency, which can be fatal to the pregnant woman and the fetus if left untreated.
•
Do not withhold life-sustaining therapy due to the potential concerns about the effect of cangrelor on the fetus.
Breastfeeding
Little information available on breastfeeding safety.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
•
Dyspnea
Uncommon < 1%
•
ICH
Unknown frequency
•
Anaphylactoid reactions, anaphylactic shock, angioedema, bronchospasm, ecchymosis, gastrointestinal bleeding, hematuria, retroperitoneal hemorrhage, wheezing
Interactions
Drug(s)
Check Interactions
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