[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Soluble guanylate cyclase (sGC) stimulators](https://durgical.com/en/pharmacology/classes/soluble-guanylate-cyclase-stimulators/) › Vericiguat

# Vericiguat

## Soluble guanylate cyclase (sGC) stimulators?

Soluble guanylate cyclase (sGC) stimulators

## Pregnancy: contraindicated?

Contraindicated: it may harm the fetus; a negative pregnancy test is required before starting and reliable contraception during treatment and for a month after.

An oral sGC stimulator added to standard therapy in heart failure with reduced ejection fraction after a recent worsening, to cut deaths and admissions.

Updated Nov 1, 2026

## Quick facts

**Group**
[Soluble guanylate cyclase (sGC) stimulators](https://durgical.com/en/pharmacology/classes/soluble-guanylate-cyclase-stimulators/)

**Target**
Soluble guanylate cyclase (α1β1), the nitric oxide receptor

**Used for**
Symptomatic chronic heart failure

**Key effects**
Low blood pressure · Dizziness and lightheadedness

**Monitor**
Blood pressure · Haemoglobin

**ATC**
C01DX22

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

✂**Soluble guanylate cyclase (α1β1), the nitric oxide receptor**Vericiguat

ⓘ The figure shows riociguat bound to human soluble guanylate cyclase; vericiguat is a close relative that binds the same stimulator site.

**Target in 3D:** Soluble guanylate cyclase (α1β1), the nitric oxide receptor. PDB structure 7D9R (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7D9R) · Drag to rotate · pinch to zoom

In heart failure, nitric oxide signalling and cGMP production are impaired, which contributes to stiff, constricted vessels and a struggling myocardium. Vericiguat stimulates soluble guanylate cyclase directly and sensitizes it to the body's own NO, like riociguat but with a longer half-life. More cGMP relaxes vascular smooth muscle and is thought to improve cardiac and vascular function.

- Binds sGC at the stimulator site
- Stimulates sGC and sensitizes it to nitric oxide
- cGMP rises in vessels and heart
- Vessels relax; fewer deaths and HF admissions

## Indications

- Symptomatic chronic heart failure with reduced ejection fraction after a recent worsening event (hospitalization or outpatient IV diuretics), to reduce cardiovascular death and heart failure hospitalization [Heart failure →](https://durgical.com/en/conditions/heart-failure/)

## Adverse effects

### Common

- Low blood pressure
- Dizziness and lightheadedness
- Anaemia (pale skin, tiredness, breathlessness)

### Serious (rare, important)

- Symptomatic hypotension
- Embryo-fetal toxicity

## Contraindications

- Pregnancy
- Use with another sGC stimulator (riociguat)

## Key interactions

**Riociguat**
Two sGC stimulators together; contraindicated.

**Other vasodilators and antihypertensives**
Additive fall in blood pressure.

## What is monitored

- Blood pressure, especially when the dose is raised
- Haemoglobin
- Pregnancy test before starting in people who could become pregnant
- Heart failure symptoms and weight

## Administration and safety

- Oral tablet, once a day with food; may be crushed and mixed with water just before use.
- Started low and increased about every two weeks as blood pressure allows.
- Not combined with riociguat.

## Pregnancy and breastfeeding

Contraindicated: it may harm the fetus; a negative pregnancy test is required before starting and reliable contraception during treatment and for a month after.

## Nursing care

- Before: blood pressure, haemoglobin, pregnancy test, current medicines (riociguat).
- During: blood pressure, dizziness, signs of anaemia.
- Teach to rise slowly and to report fainting.
- Teach reliable contraception and not to breastfeed.

## Pharmacokinetics

**Absorption**
Oral, taken with food.

**Half-life**
Longer than riociguat's, allowing once-daily use (G&G).

## Memory aid

VERIciguat = 'VERy long riociguat for the ventricle': the same NO-receptor switch, once a day, for heart failure after a scare.

## Test yourself

Think of the answer, then tap the question to see it.

## In which patients is vericiguat used?

Symptomatic heart failure with reduced ejection fraction after a recent worsening (hospitalization or IV diuretics), on top of standard therapy.

## How does vericiguat differ from riociguat?

Same mechanism (sGC stimulator), but a longer half-life and use in heart failure rather than pulmonary hypertension.

## Which drug must never be combined with vericiguat?

Riociguat (another sGC stimulator).

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/vericiguat/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**Pregnancy: contraindicated**
Contraindicated: it may harm the fetus; a negative pregnancy test is required before starting and reliable contraception during treatment and for a month after.

## Connections

## Related drugs 3

- [Riociguat](https://durgical.com/en/pharmacology/riociguat/)
- [Sacubitril/valsartan](https://durgical.com/en/pharmacology/sacubitril-valsartan/)
- [Empagliflozin](https://durgical.com/en/pharmacology/empagliflozin/)

## Related conditions 1

- [Heart failure](https://durgical.com/en/conditions/heart-failure/)

[← Back to the class: Soluble guanylate cyclase (sGC) stimulators](https://durgical.com/en/pharmacology/classes/soluble-guanylate-cyclase-stimulators/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Vericiguat: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a621014.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [Structure of huamn soluble guanylate cyclase in the riociguat and NO-bound state](https://www.rcsb.org/structure/7D9R) (RCSB Protein Data Bank, 2021); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C01DX22) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/vericiguat/
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