Vericiguat: Uses, Interactions and Safety
Uses
Vericiguat stimulates soluble guanylate cyclase and is added to other treatment for selected adults with symptomatic chronic heart failure and reduced ejection fraction after a recent worsening event. It is intended for patients who have been stabilised after decompensation, rather than for self-treatment of sudden breathlessness or swelling.
Administration
The tablet is taken by mouth with food. The heart-failure team adjusts treatment according to blood pressure and tolerability. Continue the other prescribed heart-failure medicines unless the clinician changes them. A missed dose or difficulty swallowing should be discussed using the instructions for the prescribed product.
Safety
Low blood pressure and anaemia are important concerns. Report fainting, troublesome dizziness, unusual weakness or worsening heart-failure symptoms. Fluid status and blood pressure should be assessed before starting. People with very low blood pressure, dialysis or severe liver impairment need particular review because evidence is limited.
Interactions
Riociguat or another soluble guanylate-cyclase stimulator is contraindicated. Combining vericiguat with a PDE5 inhibitor is not recommended because symptomatic hypotension may increase; the US avanafil label specifically contraindicates its use with vericiguat. Nitrates are not subject to the same blanket prohibition as with riociguat, but blood pressure and limited long-acting nitrate experience still require assessment. Sacubitril/valsartan is an established compatible background treatment.
Pregnancy and breastfeeding
It should not be used in pregnancy. US labelling explicitly lists pregnancy as a contraindication and requires effective contraception during treatment and for one month afterwards. Human milk data are lacking; breastfeeding and treatment decisions require discussion, and US labelling recommends not breastfeeding.
Adverse effects
Hypotension and anaemia are the main adverse effects. Dizziness, headache, nausea and indigestion can occur. Do not change treatment solely because a new symptom resembles a listed adverse effect; the heart-failure team should assess it.
Sources
The linked Turkish profile contains the medicine record and its documented interaction list.