Cangrelor

Class: Platelet-aggregation Inhibitors
Chemical Name: N-[2-(Methylthio)ethyl]-2-[(3,3,3-trifluoropropyl)thio]-5′-adenylic acid monoanhydride with (dichloromethylene)bis[phosphonic acid] tetrasodium salt
Molecular Formula: C₁₇H₂₁Cl₂F₃N₅Na₄O₁₂P₃S₂
CAS Number: 163706-36-3
Brands: Kengreal

Medically reviewed by Drugs.com on Dec 15, 2021. Written by ASHP.

Introduction

Platelet-activation and -aggregation inhibitor; nonthienopyridine, reversible, P2Y12 platelet adenosine diphosphate (ADP)-receptor antagonist.

Uses for Cangrelor

Acute Ischemic Complications of PCI

Used as an adjunct to PCI to reduce the risk of periprocedural MI, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12-receptor antagonist and are not being given a glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitor.

Dual antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor is considered the current standard of care in patients undergoing PCI.

Cangrelor is the only currently available IV P2Y12 receptor inhibitor. Compared with oral P2Y12 inhibitors (clopidogrel, prasugrel, ticagrelor), cangrelor has a rapid onset and offset of action; following an IV bolus dose, platelet inhibition is immediate and can be maintained with continuous IV infusion.

May be useful in patients who cannot take oral medications (e.g., intubated patients or those with shock, cardiac arrest, or nausea/vomiting) or patients who may benefit from a rapidly acting or reversible agent (e.g., those who have bleeding complications with PCI or are candidates for emergent invasive procedures such as CABG).

Cangrelor Dosage and Administration

General

• Intended to be given to patients prior to PCI in conjunction with other standard-of-care therapy (e.g., aspirin, anticoagulants).

Administration

IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

Must reconstitute commercially available lyophilized powder and further dilute prior to administration.

Administer by rapid IV (“bolus”) injection (over <1 minute) from the prepared IV infusion bag via manual IV push or infusion pump, followed by IV infusion.

Reconstitution

Reconstitute vial containing 50 mg of lyophilized cangrelor with 5 mL of sterile water for injection (swirl gently).

Dilution

Dilute reconstituted solution in 250 mL of 5% dextrose or 0.9% sodium chloride injection to a final concentration of 200 mcg/mL.

Rate of Administration

Rapid IV (“bolus”) injection: Administer over <1 minute.

Continuous IV infusion: Administer for at least 2 hours or for duration of PCI, whichever is longer.

Dosage

Available as cangrelor tetrasodium; dosage expressed in terms of cangrelor.

Adults

Acute Ischemic Complications of PCI

IV

30 mcg/kg by rapid IV (“bolus”) injection prior to PCI, immediately followed by 4 mcg/kg per minute by continuous IV infusion for at least 2 hours or for t...