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

Drugs in this class (2)

Riociguat ballicule — decagon mechanism diagram — Riociguat

Vericiguat ballicule — decagon mechanism diagram — Vericiguat

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