After discontinuation of cangrelor infusion, the antiplatelet effect decreases rapidly and platelet function returns to baseline within 1 hour.

A bolus dose of cangrelor 30 mcg/kg should be administered intravenously at the time of PCI, followed immediately by an infusion of 4 mcg/kg/min. The infusion should be continued for at least 2 hours, or for the duration of PCI, whichever is longer.

• If you plan to transition your patient to ticagrelor, a loading dose of 180 mg may be given at any time during the cangrelor infusion, or immediately after discontinuation
• If you plan to transition your patient to prasugrel, a loading dose of 60 mg may be given at the end of cangrelor infusion (immediately after discontinuation)
• If you plan to transition your patient to clopidogrel, a loading dose of 600 mg may be given at the end of cangrelor infusion (immediately after discontinuation)

The expected antiplatelet effect of a 600 mg loading dose of clopidogrel or a 60 mg loading dose of prasugrel was blocked when administered during a cangrelor infusion, resulting in no antiplatelet effect from clopidogrel or prasugrel until the next dose is administered.

In contrast, the antiplatelet effect of a 180 mg ticagrelor loading dose was not altered significantly when ticagrelor was administered during cangrelor infusion.

Cangrelor pharmacokinetics are not affected by renal status, therefore no dosage adjustment is required for patients with mild, moderate, or severe renal impairment.

Worsening renal function was reported in 3.2% of cangrelor patients with severe renal impairment (creatinine clearance <30 mL/min) compared to 1.4% of clopidogrel patients with severe renal impairment.