Kengreal (cangrelor tetrasodium)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Cangrelor tetrasodium, a nonthienopyridine, reversible P2Y12 platelet adenosine diphosphate (ADP)-receptor antagonist, is a platelet-activation and -aggregation inhibitor.
Cangrelor is a nonthienopyridine, direct-acting, P2Y12 ADP-receptor antagonist. Unlike the thienopyridine prodrugs clopidogrel and prasugrel but like ticagrelor, cangrelor does not require hepatic transformation to exert its pharmacologic effects. Cangrelor, like ticagrelor, binds reversibly to the P2Y12 platelet ADP receptor, preventing signal transduction of the cyclic adenosine monophosphate (cAMP) pathway.
This action results in reduced exposure of fibrinogen binding sites to the platelet glycoprotein IIb/IIIa complex and subsequent inhibition of platelet activation and aggregation.
After administration of a 30-mcg/kg IV loading dose followed by a 4-mcg/kg per minute IV infusion, peak plasma concentrations of cangrelor are reached within 2 minutes. Unlike clopidogrel, cangrelor does not require metabolic activation and as a result is not associated with interindividual variability in plasma concentrations. Cangrelor is deactivated rapidly in circulation by dephosphorylation to its primary metabolite, a nucleoside, which has negligible antiplatelet activity.
Cangrelor is eliminated principally in urine (58% of the dose) and to a lesser extent in feces (35%). Because of its short half-life (3-6 minutes) and reversible binding to the P2Y12 receptor, cangrelor has a rapid offset of effect that allows recovery of platelet function within 1 hour after cessation of IV infusion.
Generic name: cangrelor tetrasodium
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
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Indications
The following indications are listed for Kengreal:
- Percutaneous Coronary Intervention Adjunct For Thrombosis Prevention
Dosing
Dosage of cangrelor tetrasodium is expressed in terms of cangrelor. Cangrelor is intended to be given to patients prior to PCI in conjunction with other standard-of-care therapy (e.g., aspirin, anticoagulants). Upon discontinuance of the cangrelor infusion, patients should be transitioned to an oral P2Y12 inhibitor to maintain platelet inhibition.
No dosing information is available for this tab.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
Cangrelor is contraindicated in patients with substantial active bleeding and in those with known hypersensitivity to the drug or any ingredient in the formulation.
There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
The most common adverse effect of cangrelor reported in clinical trials was bleeding. Cases of transient dyspnea were also reported during clinical trials.
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
No enhanced messaging available.
Safety and efficacy of cangrelor have not been established in pediatric patients.
There are no adequate and well-controlled studies of cangrelor in pregnant women. Cangrelor did not produce malformations in animal reproduction studies and is not considered to be a teratogen. In embryofetal development studies in animals, cangrelor produced dose-related fetal growth retardation in rats and rabbits. In addition, the drug increased incidences of abortion and intrauterine losses in rabbits.
It is not known whether cangrelor is distributed into human milk. Because of the potential for serious adverse reactions to cangrelor in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman.
In the CHAMPION PHOENIX trial, 18% of the patients were 75 years of age or older. No overall differences in safety or efficacy were observed between these patients and those younger than 75 years of age.
No differences in safety or effectiveness have been identified between patients 75 years of age or older and younger patients.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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