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Verquvo
vericiguat
Black Box Warnings .
Embryo-Fetal Toxicity
contraindicated in pregnancy; exclude pregnancy in patients of childbearing potential prior to tx start; use effective methods of contraception during tx and x1mo after D/C
Adult Dosing .
Dosage forms: TAB: 2.5 mg, 5 mg, 10 mg
heart failure w/ reduced ejection fraction, symptomatic
- [10 mg PO qd]
- Start: 2.5 mg PO qd, then double dose q2wk as tolerated; Info: for patients recently hospitalized for heart failure, or receiving outpatient IV diuretic tx; give w/ food
renal dosing
- [see below]
- eGFR >15: no adjustment; eGFR <15: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pregnancy
- breastfeeding
- caution: patients of childbearing potential
Drug Interactions .
Overview
vericiguat
soluble guanylate cyclase (sGC) stimulator
- vasodilator agent
Contraindicated
- avanafil
- riociguat
- sildenafil
- tadalafil
- vardenafil
Avoid/Use Alternative
- nitroprusside
Monitor/Modify Tx
- cilostazol
- dipyridamole
- epoprostenol
- hydralazine
- iloprost
- iloprost inhaled
- isosorbide dinitrate
- isosorbide mononitrate
- milrinone
- nitric oxide
- nitrite
- nitroglycerin
- sacubitril
- treprostinil
Caution Advised
- verteporfin
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline
Pregnancy/Lactation .
Pregnancy
Clinical Summary
contraindicated during pregnancy; no human data available; risk of teratogenicity and embryo-fetal death based on animal data at up to 24x MRHD
Pregnancy Reporting
report any prenatal exposure to Verquvo pregnancy surveillance program at 1-877-888-4231 or at https://pregnancyreporting.verquvo-us.com
Individuals of Reproductive Potential
obtain negative pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x1mo after D/C in patients of childbearing potential
Lactation
Clinical Summary
avoid use while breastfeeding; no human data available to assess risk of infant harm, though possible drug excretion into milk based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: glucuronidation; CYP450: minimal (<5%); UGT: 1A1, 1A9 (primary) substrate
Excretion: urine 53% (none unchanged), feces 45% (100% unchanged); Half-life: 30h
Subclass: soluble Guanylate Cyclase (sGC) Stimulators
Mechanism of Action
stimulates binding of soluble guanylate cyclase (sGC) to nitric oxide in nitric oxide-sGC-cGMP pathway, increasing cGMP production and subsequent smooth muscle relaxation and vasodilation
Formulary .
No Formulary Selected
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