Formulary
Vericiguat: Indications, Dosing, Side Effects and Interactions
Vericiguat is a stimulator of soluble guanylate cyclase that augments levels of intracellular cyclic guanosine monophosphate, which may improve both...
MedNext Academy | 3 min read
Vericiguat: Indications, Dosing, Side Effects and Interactions
Vericiguat is a stimulator of soluble guanylate cyclase that augments levels of intracellular cyclic guanosine monophosphate, which may improve both...
Drug action
Vericiguat is a stimulator of soluble guanylate cyclase that augments levels of intracellular cyclic guanosine monophosphate, which may improve both myocardial and vascular function.
Indications and dose
**Chronic heart failure with reduced ejection fraction [in patients stabilised after a recent decompensation event requiring intravenous therapy]**
- **Adult** (By Mouth): Initially 2.5 mg once daily, dose to be doubled approximately every 2 weeks if tolerated, to maintenance dose; maintenance 10 mg once daily.
Cautions
Autonomic dysfunction; history of hypotension; hypovolaemia; resting hypotension; severe left ventricular outflow obstruction Cautions, further information Hypotension If symptomatic hypotension or systolic blood pressure less than 90 mmHg is observed during treatment, temporary dose reduction or discontinuation of vericiguat is recommended. M
Contraindications
Hypotension (do not initiate if systolic blood pressure less than 100 mmHg)
Side effects
Common or very common Anaemia; dizziness; dyspepsia; gastrooesophageal reflux disease; headache; hypotension; nausea; vomiting
Interactions
**Severe interactions:**
- Organic nitrates Co-administration of multiple doses of vericiguat increased to 10 mg once daily did not significantly alter the seated blood pressure effects of short- and long-acting nitrates...
- No significant interactions Concomitant administration of medicinal products affecting one or more of vericiguats elimination pathways does not have a clinically relevant effect on the...
**Other interactions (19):**
- Pharmacodynamic interactions Vericiguat co-administration with haemodynamic active substances did not result in a more than additive effect (see sections 4.4 and 5.1).
- In addition, vericiguat reduced systolic blood pressure by approximately 1 to 2 mmHg when co-administered with other medicinal products used in patients with heart failure (see section 4.8).
- PDE5 inhibitors Addition of single doses of sildenafil (25, 50, or 100 mg) to multiple doses of vericiguat (10 mg) once daily in healthy subjects was associated with additional seated blood pressure...
- No dose-dependent trend was observed with the different sildenafil doses.
- Concomitant use of vericiguat and PDE5 inhibitors, such as sildenafil, has not been studied in patients with heart failure and is therefore not recommended due to the potential increased risk for...
- Acetylsalicylic acid Administration of a single dose of vericiguat (15 mg) in healthy subjects did not alter the effect of acetylsalicylic acid (500 mg) on bleeding time or platelet aggregation.
Pregnancy
Avoid-toxicity in animal studies. M
Breast feeding
Avoid-present in milk in animal studies. M
Hepatic impairment
Avoid in severe impairment (no information available). M
Renal impairment
Avoid if eGFR less than 15 mL/minute/1.73 m 2 at start of treatment, or in patients on dialysis (no information available). M See Prescribing in renal impairment .
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.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Vericiguat in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

