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Cangrelor parenteral

Updated 2 Feb 2023 | P2Y12 inhibitors


Parenteral formulations of cangrelor.

Drugs List

  • cangrelor 50mg powder for concentrate for solution for injection
  • KENGREXAL 50mg powder for concentrate for solution for injection
  • Therapeutic Indications


    Coronary artery disease PCI patient: reduction of thrombotic events

    Cangrelor, co-administered with aspirin, is indicated for the reduction of thrombotic cardiovascular events in 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.



    The recommended dose of cangrelor for patients undergoing PCI is 30micrograms/kg intravenous bolus followed immediately by 4micrograms/kg/minute intravenous infusion.

    The bolus and infusion should be initiated prior to the procedure and continued for at least two hours or for the duration of the procedure, whichever is longer. At the discretion of the physician, the infusion may be continued for a total duration of four hours.

    Additional Dosage Information

    Patients should be transitioned to oral P2Y12 therapy for chronic treatment. For transition, a loading dose of oral P2Y12 therapy (clopidogrel, ticagrelor or prasugrel) should be administered immediately following discontinuation of cangrelor infusion. Alternatively, a loading dose of ticagrelor or prasugrel, but not clopidogrel, may be administered up to 30 minutes before the end of the infusion (see specific product literature).

    In patients undergoing PCI, standard procedural adjunctive therapy should be implemented.


    For intravenous administration.


    Children under 18 years
    Recent surgery
    Recent trauma
    Risk of haemorrhage
    Hereditary fructose intolerance
    History of cerebrovascular accident
    History of transient ischaemic attack
    Impaired haemostasis
    Uncontrolled severe hypertension

    Precautions and Warnings

    Predisposition to haemorrhage
    Renal impairment - creatinine clearance below 30 ml/minute

    Presentations with sorbitol unsuitable in hereditary fructose intolerance
    Must be diluted before use
    Treatment to be administered under the supervision of a specialist
    Monitor for unexplained fall in blood pressure or haematocrit
    Potential for increased risk of bleeding
    Discontinue if haemorrhage occurs
    Discontinue if unexplained fall in blood pressure or haematocrit occurs

    Cangrelor has a half-life of 3 to 6 minutes. Platelet function is restored within 60 minutes of stopping infusion.

    Pregnancy and Lactation


    Cangrelor is contraindicated during pregnancy.

    Use of cangrelor during pregnancy is contraindicated by the manufacturer. Studies in animals have shown reproductive toxicity. There is limited data on the use of cangrelor in pregnant women. Potential risks are unknown.


    Cangrelor is contraindicated during breastfeeding.

    The manufacturer makes no recommendation regarding use of cangrelor during breastfeeding. The presence of cangrelor in human breast milk is unknown. Effects on exposed infants are unknown.

    Side Effects

    Abnormal INR
    Acute renal failure
    Anaphylactic reaction
    Anaphylactic shock
    Cardiac tamponade
    Decrease in haemoglobin and haematocrit
    Discharge (injection site)
    Ear haemorrhage
    Gastro-intestinal haemorrhage
    Haematoma (injection site)
    Haematoma infection
    Haemodynamic disturbances
    Hypersensitivity reactions
    Increase in creatinine
    Intracranial bleeding
    Ocular haemorrhage
    Pelvic haemorrhage
    Penile haemorrhage
    Pericardial haemorrhage
    Periorbital haematoma
    Peritoneal haematoma
    Pulmonary haemorrhage
    Reduced platelet count
    Reduction in blood count
    Retroperitoneal bleeding
    Skin neoplasm bleeding
    Subcutaneous haematoma (injection site)
    Urinary tract bleeding
    Vascular pseudoaneurysm
    Wound haemorrhage


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: July 2019

    Reference Sources

    Summary of Product Characteristics: Kengrexal 50 mg powder for concentrate for solution for injection/infusion. Chiesi Ltd. Revised December 2019.

    NICE Evidence Services Available at: Last accessed: 11 July 2019

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