An oral tablet for chronic heart failure
Vericiguat
An oral tablet used to treat chronic heart failure, added to other heart-failure medicines.
What is Vericiguat?
Vericiguat is an oral medicine used to treat chronic heart failure, usually added on top of other heart-failure treatments in people whose condition has recently worsened. It belongs to a group called soluble guanylate cyclase stimulators, which relax blood vessels and ease the strain on the heart. The most important effects are low blood pressure and fainting, and it can cause anaemia. It must not be combined with nitrates, other guanylate cyclase stimulators or PDE5 inhibitors (such as some erectile-dysfunction medicines), and it should be avoided in pregnancy. It is started and monitored by a heart specialist.
Education and reference only. This is a plain-language guide to Vericiguat — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vericiguat is a medicine used to treat chronic heart failure, a long-term condition in which the heart does not pump as well as it should. It is generally added to other heart-failure medicines in people who have recently had a worsening of their condition, to help reduce the chance of further problems. It belongs to a group called soluble guanylate cyclase stimulators and is taken as a daily tablet by mouth. It is started and supervised by a heart specialist as part of a wider heart-failure treatment plan, and is taken alongside, rather than instead of, other treatments.
How it works
In heart failure, the signalling that helps blood vessels relax can be weakened. Vericiguat stimulates an enzyme called soluble guanylate cyclase, boosting a natural pathway that relaxes and widens blood vessels. This eases the workload on the heart and improves how blood flows. Because it relaxes blood vessels, it can lower blood pressure, which is why it is started carefully and built up under supervision. It is taken every day so this effect is steady, and it is used together with the other medicines that make up modern heart-failure treatment.
Company & origin
Originated / developed by: Specialist manufacturer.
An oral medicine used alongside other heart-failure treatments in people with chronic heart failure that has worsened.
What it treats
Conditions Vericiguat is used for
Practical use
How to take Vericiguat
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the tablet by mouth once a day, usually with food, as your heart team directs.
- Stand up slowly and tell your team if you feel dizzy or faint, as it can lower blood pressure.
- Do not take it with nitrates, other guanylate cyclase stimulators or PDE5 inhibitors, as together they can drop blood pressure dangerously.
- Keep taking your other heart-failure medicines, as vericiguat is added to them, not used instead of them.
- Use reliable contraception if you could become pregnant, as it should be avoided in pregnancy.
Weighing it up
Advantages & disadvantages of Vericiguat
Advantages
- Adds to other heart-failure treatments to help people whose condition has recently worsened.
- Works through a different pathway from many other heart-failure medicines, by relaxing blood vessels.
- Taken as a simple once-daily tablet alongside existing treatment.
Disadvantages
- Can cause low blood pressure, dizziness and fainting.
- Can cause anaemia, which needs blood-test monitoring.
- Must not be combined with nitrates, other guanylate cyclase stimulators or PDE5 inhibitors, and is avoided in pregnancy.
Practical use
Good to know
The most important everyday effects of vericiguat are low blood pressure and the dizziness or fainting that can come with it, so it helps to stand up slowly and to tell your team if you feel light-headed. It can also cause anaemia, a low red-blood-cell count, which is checked with blood tests. A crucial safety point is that it must not be combined with nitrates, with other medicines in the same guanylate cyclase group, or with PDE5 inhibitors (such as some erectile-dysfunction medicines and certain lung medicines), because together they can cause a dangerous drop in blood pressure. It should also be avoided in pregnancy, as it can harm a developing baby, so reliable contraception is important for those who could become pregnant. Taking it with food is usually advised, and it is built up gradually under specialist supervision.
Who should not take it / use with caution
- People who have had a serious allergic reaction to vericiguat should not take it.
- It must not be used with nitrates, other guanylate cyclase stimulators or PDE5 inhibitors.
- It is avoided in pregnancy and breastfeeding, as it can harm a developing baby.
- It is used with care in people with very low blood pressure, under specialist guidance.
Monitoring
- Regular blood-pressure checks, especially when treatment is started or the dose is increased.
- Blood tests to check for anaemia.
- Reviewing symptoms and the rest of the heart-failure treatment plan over time.
Side effects
- Low blood pressure, dizziness or fainting.
- Anaemia (a low red-blood-cell count), found on blood tests.
- Headache or nausea in some people.
Key interactions
- Nitrates, other guanylate cyclase stimulators and PDE5 inhibitors must not be combined with it, as blood pressure can fall dangerously.
- Other medicines that lower blood pressure can add to its effect, so the combination is watched.
- Tell your team about all your medicines, including those for erectile dysfunction or lung blood-pressure problems.
Available as: Tablets taken by mouth.
Answers
Vericiguat: frequently asked questions
What is vericiguat used for?
It is used to treat chronic heart failure, usually added to other heart-failure medicines in people whose condition has recently worsened.
Why does it make me dizzy?
It relaxes blood vessels, which can lower blood pressure and cause dizziness or fainting, so stand up slowly and tell your team if it happens.
What must I not take with it?
It must not be combined with nitrates, other guanylate cyclase stimulators or PDE5 inhibitors (such as some erectile-dysfunction medicines), as together they can drop blood pressure dangerously.
Does it replace my other heart medicines?
No. Vericiguat is added on top of your other heart-failure treatments, not used instead of them, so keep taking them as prescribed.
Is it safe in pregnancy?
No. It should be avoided in pregnancy as it can harm a developing baby, so reliable contraception is important for those who could become pregnant.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.