Soluble guanylate cyclase (sGC) stimulators
- Directly stimulate sGC + sensitize to NO
- Increase cGMP-mediated vasodilation
- Riociguat: PAH/CTEPH
- Vericiguat: selected worsening HFrEF
- Hypotension is a key adverse effect
- Never combine riociguat with PDE5 inhibitors
Class at a glance
- Directly stimulate sGC + sensitize to NO
Clinical role
- Riociguat: PAH/CTEPH
- Vericiguat: selected worsening HFrEF
Pharmacology
- Never combine riociguat with PDE5 inhibitors
Practical pearls
- Increase cGMP-mediated vasodilation
Safety / monitoring
- Hypotension is a key adverse effect
Self-check
- Which drug class must not be combined with riociguat?
PDE5 inhibitors. - Which sGC stimulator treats selected worsening HFrEF?
Vericiguat.
Drugs in this class (2)
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