cangrelor

REMS

Adjunct to percutaneous coronary intervention (PCI) in patients not currently receiving a P2Y₁₂ platelet inhibitor and are not receiving a glycoprotein IIb/IIIa inhibitor.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Significant severe bleeding.

Use Cautiously in:

OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

Hemat: bleeding

Resp: dyspnea

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of other P2Y12 inhibitors, including clopidogrel, prasugrel, or ticagrelor, ↑ risk of bleeding.
Blocks antiplatelet effects of concurrently administered clopidogrel or prasugrel; administer clopidogrel or prasugrel after cangrelor infusion is discontinued.

Availability ⬆ ⬇

Lyophilized powder for injection: 50 mg/vial

Route/Dosage ⬆ ⬇

IV (Adults ): 30 mcg/kg bolus prior to PCI, then 4 mcg/kg/min infusion for 2 hr or duration of procedure, whichever is longer; should be followed by initiation of an oral P2Y₁₂ platelet inhibitor.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits platelet aggregation by reversibly interacting with platelet P2Y₁₂ADP-receptors, preventing signal transduction and platelet activation

Therapeutic effects:

↓risk of periprocedural MI, repeat coronary revascularization or stent thrombosis associated with PCI.

Classifications ⬆ ⬇

Therapeutic Classification: antiplatelet agents

Pharmacologic Classification: platelet aggregation inhibitors

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Minimally distributed to tissues.

Protein Binding: 97–98%.

Metabolism/Excretion: Metabolized rapidly in the bloodstream; metabolites do not have antiplatelet activity. 58% excreted by kidneys, 35% in feces.

Half-Life: 3–6 min

Time/Action Profile ⬆ ⬇

(antiplatelet effect)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	2 min	1 hr‡

‡following discontinuation.

Patient/Family Teaching ⬆ ⬇

Caution patient to notify health care professional if bleeding occurs.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is suspected or if breastfeeding. Avoid neuraxial blockade procedures and, when possible, discontinue cangrelor 1 hr prior to labor, delivery, or neuraxial blockade.

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Indications ⬇