Formulary
Cangrelor: Indications, Dosing, Side Effects and Interactions
Cangrelor is a direct P2Y 12 platelet receptor antagonist that blocks adenosine diphosphate induced platelet activation and aggregation.
MedNext Academy | 3 min read
Cangrelor: Indications, Dosing, Side Effects and Interactions
Cangrelor is a direct P2Y 12 platelet receptor antagonist that blocks adenosine diphosphate induced platelet activation and aggregation.
Drug action
Cangrelor is a direct P2Y 12 platelet receptor antagonist that blocks adenosine diphosphate induced platelet activation and aggregation.
Cautions
Disease states associated with increased bleeding risk
Contraindications
Active bleeding; history of stroke; history of transient ischaemic attack; patients at increased risk of bleeding (e.g. impaired haemostasis, irreversible coagulation disorders, major surgery or trauma, uncontrolled severe hypertension)
Side effects
Common or very common Dyspnoea; haemorrhage; skin reactions Uncommon Cardiac tamponade; haemodynamic instability; renal impairment; retroperitoneal haemorrhage (including fatal cases) Rare or very rare Anaemia; haematoma infection; intracranial haemorrhage; menorrhagia; skin neoplasm haemorrhage; stroke; thrombocytopenia; vascular pseudoaneurysm; wound haemorrhage
Interactions
**Other interactions (15):**
- Oral P2Y12 agents (clopidogrel, prasugrel, ticagrelor) When clopidogrel is administered during infusion of cangrelor, the expected inhibitory effect of clopidogrel on platelets is not achieved.
- Administration of 600 mg clopidogrel immediately after the cessation of the cangrelor infusion results in the anticipated full pharmacodynamic effect.
- No clinically relevant interruption of P2Y12 inhibition was observed in phase III studies when 600 mg clopidogrel was administered immediately after discontinuation of the cangrelor infusion.
- A pharmacodynamic interaction study has been conducted with cangrelor and prasugrel, which demonstrated that cangrelor and prasugrel can be administered concomitantly.
- Patients can be transitioned from cangrelor to prasugrel when prasugrel is administered immediately following discontinuation of the cangrelor infusion or up to one hour before, optimally at 30...
- A pharmacodynamic interaction study has also been conducted with cangrelor and ticagrelor.
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises potential risk to infant -no information available.
Renal impairment
Manufacturer advises caution in severe renal impairment-increased risk of bleeding.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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