Home Drug Guide Vericiguat

Drug Guide

Generic Name

Vericiguat

Brand Names Verquvo

Classification

Therapeutic: Cardiovascular agent

Pharmacological: Soluble guanylate cyclase stimulator

FDA Approved Indications

  • Chronic heart failure with reduced ejection fraction (HFrEF) to reduce the risk of cardiovascular death and heart failure hospitalization

Mechanism of Action

Vericiguat stimulates soluble guanylate cyclase (sGC), increasing cyclic guanosine monophosphate (cGMP) levels, which leads to vasodilation, reduced preload and afterload, and improved cardiac function.

Dosage and Administration

Adult: Initially 2.5 mg once daily, titrated based on tolerability and clinical response to a maximum of 10 mg once daily.

Pediatric: Not approved for pediatric use.

Geriatric: No special dosage adjustment; monitor renal and hepatic function.

Renal Impairment: Adjust dose based on renal function; specifics not established, use with caution.

Hepatic Impairment: Potential dose reduction recommended; specific guidelines not established.

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma concentrations in about 1-2 hours.

Distribution: Protein binding approximately 94%.

Metabolism: Primarily metabolized via non-CYP pathways; including glucuronidation and oxidation.

Excretion: Excreted mainly via feces (~66%) and urine (~27%).

Half Life: Approximately 20 hours, allowing for once-daily dosing.

Contraindications

  • Hypersensitivity to vericiguat
  • Use with soluble guanylate cyclase stimulators

Precautions

  • Risk of hypotension, dizziness, anemia; monitor blood pressure and hemoglobin levels; cautious use in patients with low blood pressure or anemia.

Adverse Reactions - Common

  • hypotension (>10%)
  • anemia (<10%)
  • dizziness (>10%)
  • headache (>10%)

Adverse Reactions - Serious

  • hypotension requiring intervention (Rare)
  • syncope (Rare)
  • hypersensitivity reactions (Rare)

Drug-Drug Interactions

  • Nitrate medications (risk of severe hypotension)
  • Other antihypertensives (potentiation)

Drug-Food Interactions

  • No significant interactions reported

Drug-Herb Interactions

  • No well-documented interactions

Nursing Implications

Assessment: Monitor blood pressure, heart rate, and symptoms of hypotension; assess for signs of anemia.

Diagnoses:

  • Risk for hypotension
  • Ineffective tissue perfusion

Implementation: Administer once daily, same time each day; monitor blood pressure regularly; educate patient on symptoms of hypotension.

Evaluation: Assess efficacy in reducing heart failure hospitalizations; monitor for adverse reactions and adverse drug reactions.

Patient/Family Teaching

  • Take medication as prescribed, at the same time daily.
  • Report symptoms of hypotension (dizziness, lightheadedness) or unexplained fatigue.
  • Avoid concomitant use of nitrates or other blood pressure-lowering agents without consulting healthcare provider.

Special Considerations

Black Box Warnings:

  • None issued for vericiguat at this time.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May cause anemia; monitor hemoglobin and hematocrit levels.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, syncope.

Treatment: Supportive care; monitor vital signs; no specific antidote; consider activated charcoal if ingestion was recent; provide IV fluids as needed.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions; protect from moisture and light.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.