Cangrelor

Cangrelor is a medication used in the treatment of patients undergoing percutaneous coronary intervention (PCI), and acts to lower the risk of heart attack and blood clots by preventing certain clotting types within the blood.

Overview:

Cangrelor is an intravenous medication that is both direct-acting and reversible. It acts as an inhibitor for P2Y12 receptors and is used in patients who are undergoing percutaneous coronary intervention (PCI).

This medication is primarily used by patients who have not yet undergone treatment with oral P2Y12 inhibitors. The intravenous form of this medication makes it more efficient than oral medicines as it does not require metabolic conversion. This allows Cangrelor to have a more rapid onset as well as offset of action.

Cangrelor acts to create a lower risk of both heart attack and blood clots by preventing certain cells within the blood from clotting, which helps to lower this risk. Stroke or a heart attack may occur when blood vessels in the brain/heart are blocked by a clot. Due to this effect, this medication may increase bleeding in some patients.

Cangrelor has been approved for this usage since June 2015 in intravenous format.

Conditions Treated:

  • Decreased risk of heart attack and blood clots in patients undergoing percutaneous coronary intervention (PCI)

Type of Medicine:

  • ADP-Induced Aggregation Inhibitor
  • Powder for Solution (intravenous)

Side Effects:

Alongside the effects Cangrelor is developed to produce, such as preventing clotting, this drug may also cause additional unwanted side effects. Not all, if any, of the listed side effects, will occur in every patient. If they do become present at any point of treatment, it is critical for the patient to seek medical attention from their doctor as soon as possible.

Should any of the following effects occur, it is important to consult with a medical professional as soon as possible:

  • Abdominal or stomach pain or swelling
  • Back pain
  • Black, tarry stools
  • Blood in the eyes
  • Blood in the urine
  • Bruising or purple areas on the skin
  • Cough
  • Coughing up blood
  • Decreased alertness
  • Difficult/labored breathing
  • Increased difficulty when swallowing
  • Fast heartbeat
  • Dizziness
  • Headache
  • Hives/itching/rash
  • Joint pain or swelling
  • Swelling like hives present on the face, including the lips, tongue, eyelids, as well as the throat, feet, hands, legs, or sexual organs
  • Noisier breathing
  • Nosebleeds
  • Swelling or puffiness of the eyelids or around the face, eyes, tongue or lips
  • Tightness or pain in the chest area
  • Unusual levels of tiredness/weakness

Cangrelor may trigger an allergic reaction. Any signs of an allergic reaction to this medication such as hives, swelling of the face, lips, tongue, or throat, or difficulty breathing should be reported to an appropriate medical professional immediately.

Dosage:

The recommended dosage of KENGREAL, the US brand name for Cangrelor, is a 30 mcg/kg IV bolus followed immediately by a 4 mcg/kg/min IV infusion.

Due to the nature of this medication, it is administered in a medical setting by a medical professional, and therefore the usage of this drug is strictly controlled by the patient’s doctor or medical team.

Interaction:

Many drugs may interact with other medications already within the human body, whether currently in use or previously in use, which can also lead to the effects of medication changing, and more side effects that could cause Cangrelor to become ineffective or cause harm to the patient.

Patients and physicians should ensure that they keep an up-to-date list of every medication and drug currently in use. This is in order to prevent issues with drug interaction, and to build a fully realized overview of the patient’s medical history as well current or past reactions to drugs that may influence the medical professional’s decision to prescribe Cangrelor as a viable medication.

It’s critical that the patient’s medical team or doctor is fully aware of every single drug within their system, from longer-term medication to over the counter products, and makes their medical professional aware of all of their recent medication usage to ensure treatment that is effective and is less likely to cause harm. These medications may cause potential moderate interaction with Cangrelor:

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Apixaban
  • Argatroban
  • Bivalirudin
  • Bromfenac
  • Bufexamac
  • Celecoxib
  • Choline Salicylate
  • Citalopram
  • Clonixin
  • Dabigatran Etexilate
  • Danaparoid
  • Desirudin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Edoxaban
  • Escitalopram
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • Heparin
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lepirudin
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Paroxetine
  • Phenindione
  • Phenprocoumon
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Protein C
  • Rivaroxaban
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sertraline
  • Sodium Salicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Valdecoxib
  • Vilazodone
  • Vortioxetine

Certain medications are not advised to be used at or around the time of consuming certain types of food. This is because depending on the contents of the food interactions may occur. Using tobacco or alcohol with certain prescribed medications may lead to interactions occurring. It is important that the patient discusses their use of medication and potential interactions with food, alcohol, or tobacco with their doctor.

Other medical issues or conditions, both present or past, may affect how this medication functions, which can result in side effects, illness or other negative effects. A doctor should be consulted if the patient has suffered from any of the following:

  • Active bleeding
  • History of stroke
  • History of transient ischaemic attack

Warnings:

Drugs that inhibit platelet P2Y12 function, such as Cangrelor, can increase the risk of bleeding in patients. As such, it’s likely that patients will bleed more if injured and are also more likely to experience extensive bruising in comparison to before their treatment began. It is advisable that patients undergoing treatment with Cangrelor should be aware of increased risk from sports and other activities that may cause harm or injury.

If the patient experiences an injury that causes increased bleeding beyond a superficial wound, it is advisable that they contact a medical professional as soon as possible and receive medical attention.

If the patient is planning on becoming pregnant, their doctor should be informed prior to the decision to take Cangrelor. This medication is FDA category C, meaning there may be some risk to the fetus, though the full extent of this risk is unknown. Should you become pregnant while on the medication, a medical professional should be informed immediately, as the use of Cangrelor during pregnancy is not considered risk-free, and may result in unforeseen problems or issues.

It is unknown if breastfeeding will cause harm to the infant, and as such it is recommended that the patient and medical professional actively weigh the risk factors involved while nursing when using Cangrelor.

Storage:

Cangrelor medication is only available to medical practices, and is not openly available to the public. As such, it should be stored in an appropriate location that is safe and secure.

KENGREAL, the US brand name for Cangrelor, is available in a powder that is sterile lyophilized, and comes in the following amounts:

  • 10 mL vial - of which contains 50 mg cangrelor
  • 10 count of 10 mL vial - of which contains 50 mg cangrelor

This medication should be kept at a fully controlled and consistent USP room temperature, that is between 20°C to 25°C (or 68°F to 77°F), with variances between 15°C and 30°C (or 59°F and 86°F) acceptable. As with all medications, Cangrelor should be stored securely, beyond the reach of children and pets as well as in a dry, non-humid environment away from direct sunlight.

Extra, unused or not needed drugs should be thrown away in the correct way to ensure that no one can consume them accidentally, as this can cause harm. However, you cannot flush this or any other medications down the toilet. The best way to dispose of your drugs is through a medicine take-back program. Talk to your pharmacist or a local garbage/recycling department to learn more about the take-back programs offered in the local community.

Summary:

Cangrelor is commonly used as an intravenous medication for use on patients who are undergoing percutaneous coronary intervention (PCI). It works by inhibiting P2Y12 receptors in order to prevent certain forms of clotting that can be of high risk for causing heart attacks, strokes and blood clots.

The intravenous form of Cangrelor is much faster than oral medicines, with treatment received in around two minutes in some cases. Intravenous route does not require metabolic conversion. This fast approach allows Cangrelor to have a more rapid onset as well as offset of action.

Cangrelor works to prevent the blood from clotting in certain ways, and as such can be a more high-risk solution for patients who may experience superficial injury in their day-to-day life, such as those who play sports or perform labor intensive work.

This medication can prompt an allergic reaction, and also can interact with a variety of different medications that the patient may already be taking. It is important that all parties, including medical professionals, are fully informed prior to the patient undergoing treatment with this form of medication, in order to avoid any issues from drug interactions.

Cangrelor has been FDA approved since June 2015 as an effective form of treatment for patients undergoing percutaneous coronary intervention (PCI).

Resources
Last Reviewed:
December 22, 2017
Last Updated:
December 22, 2017