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Cangrelor

Brand names: KENGREAL

Therapeutic Indications

Cangrelor is indicated for:

Coronary artery disease undergoing percutaneous coronary intervention (PCI)

Irrespective of gender only Adults (18 years old or older)

Cangrelor, co-administered with acetylsalicylic acid (ASA), is indicated for the reduction of thrombotic cardiovascular events in adult patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) who have not received an oral P2Y12 inhibitor prior to the PCI procedure and in whom oral therapy with P2Y12 inhibitors is not feasible or desirable.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Intravenous - 4-30 μg/kg

Contraindications

Active ingredient Cangrelor is contraindicated in the following cases:

Bleeding, increased risk of bleeding

No gender/age discrimination

Active bleeding or increased risk of bleeding, because of impaired haemostasis and/or irreversible coagulation disorders or due to recent major surgery/trauma or uncontrolled severe hypertension.

Treatment with cangrelor may increase the risk of bleeding.

In pivotal studies conducted in patients undergoing PCI, GUSTO (Global Use of Strategies to Open Occluded Arteries), moderate and mild bleeding events were more common in patients treated with cangrelor than in patients treated with clopidogrel.

Although most bleeding associated with the use of cangrelor occurs at the site of arterial puncture, haemorrhage can occur at any site. Any unexplained fall in blood pressure or haematocrit should lead to the serious consideration of a haemorrhagic event and the cessation of cangrelor administration. Cangrelor should be used with caution in patients with disease states associated with an increased bleeding risk. Cangrelor should be used with caution in patients taking medicines that may increase the risk of bleeding.

Cangrelor has a half-life of three to six minutes. Platelet function is restored within 60 minutes of stopping infusion.

Intracranial haemorrhage

Treatment with cangrelor may increase the risk of intracranial haemorrhage. In pivotal studies conducted in patients undergoing PCI, there were more intracranial bleeds at 30 days with cangrelor (0.07%) than with clopidogrel (0.02%), of which 4 bleeds with cangrelor and 1 bleed with clopidogrel were fatal. Cangrelor is contraindicated in patients with any history of stroke/TIA.

Cardiac tamponade

Treatment with cangrelor may increase the risk of cardiac tamponade. In pivotal studies conducted in patients undergoing PCI, there were more cardiac tamponades at 30 days with cangrelor (0.12%) than with clopidogrel (0.02%).

Stroke, transient ischaemic attack (TIA)

No gender/age discrimination

Any history of stroke or transient ischaemic attack (TIA).

Treatment with cangrelor may increase the risk of intracranial haemorrhage. In pivotal studies conducted in patients undergoing PCI, there were more intracranial bleeds at 30 days with cangrelor (0.07%) than with clopidogrel (0.02%), of which 4 bleeds with cangrelor and 1 bleed with clopidogrel were fatal. Cangrelor is contraindicated in patients with any history of stroke/TIA.