KENGREAL^® (cangrelor)
Dosing & Administration

Hello, my name is Tiffany. I’m a registered nurse in the adult cardiac cath lab. This video will demonstrate the procedure to prepare and administer KENGREAL, cangrelor, for injection as presented in the KENGREAL full prescribing information. Indication: KENGREAL is a P2Y₁₂ platelet inhibitor indicated as an adjunct to percutaneous coronary intervention, or PCI, to reduce the risk of periprocedural myocardial infarction, MI, repeat coronary revascularization in stent thrombosis, ST, in patients who have not been treated with a P2Y₁₂ platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor. Important safety information: KENGREAL is contraindicated in patients with significant active bleeding. KENGREAL is contraindicated in patients with known hypersensitivity. Example, anaphylaxis to KENGREAL or any component of the product. Drugs that inhibit platelet P2Y₁₂ function, including KENGREAL, increase risk of bleeding. In CHAMPION PHOENIX, bleeding events of all severities were more common with KENGREAL than with clopidogrel. Bleeding complications with KENGREAL were consistent across a variety of clinically important subgroups. Once KENGREAL is discontinued, there is no antiplatelet effect after an hour. The most common adverse reaction is bleeding. Instructions: use a clean surface to reconstitute KENGREAL, wash hands and don gloves. Use alcohol pad to wipe top of KENGREAL vial and port of 250-mL normal saline or dextrose 5% bag before each needle insertion. Preparation: KENGREAL is intended for IV administration as a bolus and an infusion after reconstitution and dilution. For each 50-mg vial, reconstitute by adding 5 mL of sterile water for injection. Swirl gently until all material is dissolved. Avoid vigorous mixing, allow any foam to settle, ensure that the contents of the vial are fully dissolved, and the reconstituted material is a clear, colorless to pale yellow solution. Reconstitute the vial prior to dilution in a bag. Parenteral drug products should be inspected visually for particulate matter after reconstitution. Do not use without dilution. Before administration, each reconstituted vial must be diluted further with normal saline, sodium chloride injection, 0.9% USP or 5% dextrose injection USP. Withdraw the contents from one reconstituted vial and add to one 250-mL saline or dextrose bag. Mix the bag thoroughly. This dilution will result in a concentration of 200 mcg per milliliter and should be sufficient for at least 2 hours of dosing. Patients 100 kg and over will require a minimum of 2 bags. Reconstituted KENGREAL should be diluted immediately. Diluted KENGREAL is stable for up to 12 hours in 5% dextrose injection and 24 hours in normal saline at room temperature, discard any unused portion of reconstituted solution remaining in the vial. Recommended dosing: The recommended dosage of KENGREAL is a 30 mcg per kilogram IV bolus followed immediately by a 4 mcg per kilogram per minute IV infusion. Initiate the bolus infusion prior to PCI. The maintenance infusion should ordinarily be continued for at least 2 hours or for the duration of PCI, whichever is longer. Administration of bolus and infusion: administer KENGREAL via a dedicated IV line. Step 1: bolus. Remove the bolus dose from the diluted solution, never from the reconstituted vial. Administer the bolus volume rapidly less than 1 minute from the diluted bag via manual IV push or pump. Ensure the bolus is completely administered before the start of PCI. Step 2: infusion. Begin infusion immediately after the bolus and continue for at least two hours or for the duration of PCI, whichever is longer. This concludes our presentation on the KENGREAL dosing and administration instructions. Please see the full prescribing information link on this page. Thank you for watching.