Cangrelor

What is Cangrelor?

• Cangrelor (Kengreal) is a P2Y12 platelet inhibitor used to prevent the formation of harmful blood clots in the coronary arteries for adult patients undergoing percutaneous coronary intervention.

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What are the uses of this medicine?

• This medicine is used as an adjunct to percutaneous coronary intervention (PCI) to reduce the risk of periprocedural myocardial infarction (MI), repeat coronary revascularization, and stent thrombosis (ST) in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor.

How does this medicine work?

• Cangrelor (kan' grel or) is a non-thienopyridine, reversible inhibitor of adenosine diphosphate (ADP) receptors (P2Y 12) on platelets and is used to decrease the risk of recurrent coronary thromboses in patients who undergo coronary interventions.
• Activated platelets release ADP which binds to ADP platelet receptors, causing activation of intracellular glycoprotein IIb/IIIA complex which triggers platelet adherence and aggregation.
• The aggregation of platelets plays an important role in the growth of atheromatous plaques, which can lead to coronary, cerebral and peripheral arterial occlusions.
• Cangrelor has a rapid onset of action and short-half life, making it an appropriate agent for short term intravenous use.
• In clinical trials, cangrelor therapy during acute coronary events (unstable angina and myocardial infarction) was shown to decrease the frequency of recurrence of myocardial infarction and stent thromboses.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• significant active bleeding
• known hypersensitivity (e.g., anaphylaxis) to Kengreal or any component of the product

What drug interactions can this medicine cause?

• Do not administer Clopidogrel, Prasugrel during Kengreal infusion.

Is this medicine FDA approved?

• It was approved for use in the United States in 2015.

How should this medicine be used?

Recommended Dosage:

• The recommended dosage of Kengreal is a 30 mcg/kg IV bolus followed immediately by a 4 mcg/kg/min IV infusion.
• Initiate the bolus infusion prior to PCI.
• The maintenance infusion should ordinarily be continued for at least 2 hours or for the duration of PCI, whichever is longer.

To maintain platelet inhibition after discontinuation of Kengreal infusion, administer an oral P2Y12 platelet inhibitor, as described below:

• Ticagrelor: 180 mg at any time during Kengreal infusion or immediately after discontinuation.
• Prasugrel: 60 mg immediately after discontinuation of Kengreal.
• Clopidogrel: 600 mg immediately after discontinuation of Kengreal

Administration

• Kengreal is intended for IV administration, after reconstitution and dilution.
• Administer Kengreal via a dedicated IV line.
• Administer the bolus volume rapidly (<1 minute), from the diluted bag via manual IV push or pump.
• Ensure the bolus is completely administered before the start of PCI.
• Start the infusion immediately after administration of the bolus.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Single-use 10 mL vial containing 50 mg Kengreal as a lyophilized powder for reconstitution.

This medicine is available in fallowing brand namesː

• Kengreal

What side effects can this medication cause?

The most common side effects of this medicine include:

• bleeding

What special precautions should I follow?

• Drugs that inhibit platelet P2Y12 function, including Kengreal, increase the risk of bleeding. Once Kengreal is discontinued, there is no antiplatelet effect after an hour.

What to do in case of emergency/overdose?

• There is no specific treatment to reverse the antiplatelet effect of Kengreal but the effect is gone within one hour after the drug is discontinued.

Can this medicine be used in pregnancy?

• There are no available data on cangrelor use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes.

Can this medicine be used in children?

• Safety and effectiveness in pediatric patients have not been established.

What are the active and inactive ingredients in this medicine?

• Active ingredient:

CANGRELOR

• Inactive ingredients:

MANNITOL SORBITOL SODIUM HYDROXIDE

Who manufactures and distributes this medicine?

• Distributed by:
• Chiesi USA, Inc.
• Cary
• Kengreal® is a registered trademeark of Chiesi Farmaceutici S.p.A.

What should I know about storage and disposal of this medication?

• Vials of Kengreal should be stored at USP Controlled Room Temperature, [20°C to 25°C (68°F to 77°F) with excursions between 15°C and 30°C (59°F and 86°F) permitted].

• Dailymed label info on Cangrelor
• FDA Cangrelor

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