Vericiguat
Vericiguat is a heart medication used to reduce the risk of cardiovascular death and heart failure hospitalization in adults with chronic heart failure.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Vericiguat (Verquvo), on the market since about 2021, is a newer add-on to heart failure medicines for adults with reduced ejection fraction (a weakened heart pump) who recently needed a hospital stay or IV fluid-clearing medicine, lowering the risk of heart-related death and hospitalization by helping blood vessels relax through the nitric oxide pathway. Most people tolerate it well, and what they notice is dizziness from low blood pressure or tiredness from anemia (low red blood cells). It carries a boxed warning for harm to an unborn baby, so women who could become pregnant need a pregnancy test first and effective birth control throughout and for a month after.
Clinical pearls
- Take it with food every day, because food meaningfully boosts how much of the drug your body absorbs.
- If swallowing is hard, the tablet can be crushed and mixed with water right before you take it.
- Avoid erectile dysfunction drugs like sildenafil (PDE-5 inhibitors) with it, since blood pressure can drop dangerously low.
- Mention any nitrate you use for chest pain, such as nitroglycerin, because long-acting nitrates especially call for caution alongside it.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
WARNING: This drug can seriously harm or cause birth defects in an unborn baby and must never be taken during pregnancy. Before starting Verquvo, women who could become pregnant must take a pregnancy test to confirm they are not pregnant. During treatment and for one month after stopping, effective birth control must be used consistently. If you become pregnant while taking this medication, stop taking it and contact your doctor immediately.
Patient information guide A plain-language walkthrough of Vericiguat, written from its FDA label.
What Vericiguat is used for
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Vericiguat is used in adults with chronic heart failure to reduce the risk of serious cardiovascular outcomes.
- Verquvo (oral tablet) is indicated to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with symptomatic chronic heart failure and an ejection fraction (the percentage of blood the heart pumps out) of less than 45%, who have recently been hospitalized for heart failure or required IV diuretics as an outpatient
- Verquvo is used in addition to — not instead of — other standard heart failure medications
How Vericiguat works
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Vericiguat works by activating an enzyme called soluble guanylate cyclase (sGC), which is a key part of the body's nitric oxide signaling system. In heart failure, the heart and blood vessels don't respond well to nitric oxide, leading to stiffness and strain. By directly stimulating sGC — both on its own and together with whatever nitric oxide the body still produces — vericiguat raises levels of a molecule called cyclic GMP (cGMP). Higher cGMP levels cause blood vessel walls to relax and widen (vasodilation), which eases the workload on the heart.
Vericiguat dosage
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Verquvo tablets are taken once daily by mouth with food — food is essential because it significantly increases how much of the drug the body absorbs and makes absorption more consistent. Your prescriber will start you at a lower dose and gradually increase it approximately every two weeks until you reach the target maintenance dose, as long as you are tolerating it well.
- Patients at higher risk of low blood pressure may be started at an even lower initial dose
- If you cannot swallow the tablet whole, Verquvo may be crushed and mixed with water — do this right before you take it, not ahead of time
- Always follow your prescriber's dosing schedule; do not adjust the dose on your own
Dosing details from the FDA-approved label
From the Vericiguat prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Recommended starting dose
- 5 mg orally once daily with food
- Double the dose approximately every 2 weeks to reach the target maintenance dose of 10 mg once daily, as tolerated by the patient
- For patients unable to swallow whole tablets, may be crushed and mixed with water immediately before administration
- Patients at risk of symptomatic hypotension
- 2.5 mg orally once daily with food as the starting dose
- Double the dose approximately every 2 weeks to reach the target maintenance dose of 10 mg once daily, as tolerated by the patient
- For patients unable to swallow whole tablets, may be crushed and mixed with water immediately before administration
- Females of reproductive potential
- Obtain a pregnancy test prior to initiating treatment with VERQUVO
Read the label’s full dosing text
2 DOSAGE AND ADMINISTRATION The recommended starting dose of VERQUVO is 5 mg orally once daily with food. ( 2.1 ) For patients at risk of symptomatic hypotension, the recommended starting dose is 2.5 mg orally once daily with food. ( 2.1 ) Double the dose after approximately every 2 weeks to reach the target maintenance dose of 10 mg once daily, as tolerated by the patient. ( 2.1 ) Tablets may be crushed and mixed with water for patients unable to swallow whole tablets. ( 2.1 ) 2.1 Recommended Dosage The recommended starting dose of VERQUVO is 5 mg orally once daily with food. For patients at risk of symptomatic hypotension, the recommended starting dose is 2.5 mg orally once daily with food [see Clinical Trials Experience (6.1) ]. Double the dose approximately every 2 weeks to reach the target maintenance dose of 10 mg once daily, as tolerated by the patient. For patients who are unable to swallow whole tablets, VERQUVO may be crushed and mixed with water immediately before administration [see Clinical Pharmacology (12.3) ] . 2.2 Pregnancy Testing in Females of Reproductive Potential Obtain a pregnancy test in females of reproductive potential prior to initiating treatment with VERQUVO [see Warnings and Precautions (5.1) and Use in Specific Populations (8.3) ].
Read the full Dosage and Administration section on DailyMed →
Vericiguat side effects
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The most common side effects reported in clinical trials of Verquvo were:
Common side effects
- Low blood pressure (hypotension) — feeling dizzy or lightheaded
- Anemia — low red blood cell count, which can cause fatigue or weakness
- Anemia — a lower-than-normal red blood cell count that can cause fatigue, weakness, or shortness of breath
When to get medical help
- Call your doctor if you feel faint, very dizzy, or have a sudden drop in blood pressure
- Tell your doctor right away if you become pregnant or think you might be pregnant — this drug can harm an unborn baby
- Contact your doctor if you develop symptoms of anemia such as unusual tiredness, shortness of breath, or pale skin
If you feel faint or severely dizzy, or if you notice unusual tiredness and pale skin that could suggest anemia, contact your doctor promptly — these may need to be evaluated and managed.
Vericiguat warnings and precautions
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- Pregnancy — do not use: Verquvo can cause serious birth defects (including heart and major blood vessel malformations) and increase the risk of miscarriage based on animal studies. It is contraindicated in pregnancy. Women who could become pregnant must use effective birth control during treatment and for one month after stopping, and must have a negative pregnancy test before starting.
- Low blood pressure (hypotension): Verquvo can lower blood pressure, particularly in patients already prone to it. Your doctor may adjust your starting dose if you are at risk.
- Breastfeeding: Breastfeeding is not recommended during treatment because the drug may be present in breast milk and could harm a nursing infant.
- Drug combinations to avoid: Verquvo must not be used with other sGC stimulators. Combining with PDE-5 inhibitors is not recommended due to risk of a significant blood pressure drop.
Vericiguat interactions
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Vericiguat can interact with certain medications in ways that affect blood pressure or create a dangerous overlap in mechanism:
- Other sGC stimulators — taking another drug in the same class at the same time is contraindicated (absolutely not allowed); the combination could be dangerous
- PDE-5 inhibitors (e.g., sildenafil, used for erectile dysfunction or pulmonary hypertension) — not recommended together because the combination can cause a significant drop in blood pressure
- Long-acting nitrates — experience in heart failure patients is limited; discuss with your doctor before combining
- Short-acting nitrates — generally tolerated in heart failure patients, but your doctor should be aware you are taking both
Interactions listed in the FDA-approved label
From the Vericiguat prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Other soluble guanylate cyclase (sGC) stimulators: VERQUVO is contraindicated in patients with concomitant use of other sGC stimulators. Concomitant use is contraindicated.
- PDE-5 inhibitors: Concomitant use has the potential for hypotension. Concomitant use is not recommended.
Read the label’s full interactions text
7 DRUG INTERACTIONS PDE-5 Inhibitors: Concomitant use is not recommended. ( 7.2 ) 7.1 Other Soluble Guanylate Cyclase Stimulators VERQUVO is contraindicated in patients with concomitant use of other soluble guanylate cyclase (sGC) stimulators [see Contraindications (4) ] . 7.2 PDE-5 Inhibitors Concomitant use of VERQUVO with PDE-5 inhibitors is not recommended because of the potential for hypotension [see Clinical Pharmacology (12.2) ] .
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Vericiguat
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- Pregnant women must not take Verquvo — it can cause serious fetal harm and birth defects
- Women who could become pregnant must confirm a negative pregnancy test before starting, use effective contraception throughout treatment, and continue contraception for one month after the last dose
- Breastfeeding mothers should not take Verquvo — it is likely to pass into breast milk
- Children and adolescents — safety and effectiveness have not been established in pediatric patients
- Older adults (65 and older) — no dose adjustment is needed, though some older individuals may be more sensitive to effects
- Kidney impairment — patients with certain levels of kidney function may not need a dose adjustment, but Verquvo has not been studied in all stages of kidney disease; discuss with your prescriber
- Taking other sGC stimulators or PDE-5 inhibitors — tell your doctor, as these combinations are either contraindicated or not recommended
Vericiguat overdose
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There is limited information about what happens if someone takes too much Verquvo, but the most likely consequence is low blood pressure (hypotension). Treatment would focus on managing symptoms. Because vericiguat binds very strongly to proteins in the blood (about 98%), it is unlikely to be removed by hemodialysis (kidney dialysis machine) if an overdose occurs.
What Vericiguat does in the body
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Verquvo produces a modest reduction in systolic blood pressure (the top number in a blood pressure reading) compared to placebo. It also reduces NT-proBNP, a blood marker that rises when the heart is under stress — lower levels suggest the heart is under less strain. These effects are dose-dependent, meaning higher doses produce greater reductions. Studies show Verquvo does not appear to cause dangerous heart rhythm changes (no clinically meaningful QTc prolongation).
How your body processes Vericiguat
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When taken with food, vericiguat is very well absorbed — about 93% of the drug reaches the bloodstream. Food increases the amount absorbed and makes levels more predictable, which is why taking Verquvo with a meal matters. The drug stays in the body for a relatively long time, with a half-life (the time it takes for half the drug to leave the body) of about 30 hours in heart failure patients, and it reaches steady, stable levels in the blood after roughly 6 days of daily dosing. Vericiguat is mainly broken down in the liver through a process called glucuronidation and eliminated from the body primarily through the feces and urine.
How to store Vericiguat
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Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (between 59°F to 86°F).
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Vericiguat
54 supplements and herbal products have documented interactions with Vericiguat in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 2
- Moderate · 35
- Minor · 17
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Vericiguat: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Vericiguat — the kind of thing our pharmacy team would talk through with you at the counter.
What is Verquvo actually doing for my heart?
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Does it matter if I take it with food?
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What side effects should I actually watch out for?
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I take a medication for erectile dysfunction — is that a problem?
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I'm a woman of childbearing age — what do I need to know?
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Can I crush the tablet if I have trouble swallowing it?
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Is Vericiguat available over the counter?
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When was Vericiguat first available?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Vericiguat on HelloPharmacist
Vericiguat forms and strengths (how it comes)
Vericiguat is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Need a version that does not list lactose, a gluten source, a dye or gelatin? Inactive ingredients differ by manufacturer: see Vericiguat inactive ingredients by manufacturer.
Tablet
How this form is used
- Verquvo tablets are used to reduce the risk of cardiovascular death and heart failure hospitalization in adults with symptomatic chronic heart failure and an ejection fraction less than 45%, following a hospitalization for heart failure or a need for outpatient IV diuretics
- Verquvo tablets are taken by mouth once daily with food — food is important for proper absorption
- Verquvo tablets may be crushed and mixed with water immediately before taking if swallowing a whole tablet is difficult
- Your doctor will start Verquvo at a lower dose and increase it approximately every 2 weeks toward the target maintenance dose, as tolerated
- Patients at risk of low blood pressure may be started at a lower initial dose of Verquvo, as directed by their prescriber
Vericiguat on the U.S. market: products, makers and brands
How Vericiguat appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
1 company lists 3 Vericiguat product records with the FDA, mostly as tablet; the earliest marketing or approval year on record is 2021. Brand names on the directory include Verquvo; the rest are generics.
Also listed with the FDA, not a patient dose form: Powder (4) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
How widely Vericiguat is used (Medicaid data)
A general measure of how commonly Vericiguat is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Vericiguat is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Vericiguat prescribed? Of the 1,601 medications we measure, Vericiguat ranks #992 by Medicaid prescriptions — more than 38% of them.
Utilization by Vericiguat product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
vericiguat 10 MG Oral Tablet Most dispensed
Summed across the 2 of 5 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2475846
vericiguat 5 MG Oral Tablet
Summed across the 2 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2475858
vericiguat 2.5 MG Oral Tablet
Summed across the 2 of 7 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2475854
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Vericiguat, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 6 of 19 listed Vericiguat NDCs with Medicaid activity.
Compare Vericiguat products
A representative set of FDA-listed product records for Vericiguat — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Tablet | ||||
| 2.5 mg | Oral | Merck Sharp & Dohme LLC | NDA | View NDC → |
| 5 mg | Oral | Merck Sharp & Dohme LLC | NDA | View NDC → |
| 10 mg | Oral | Merck Sharp & Dohme LLC | NDA | View NDC → |
Showing 3 of 3 products — FDA National Drug Code Directory. See every product, package size and price: browse all 3 Vericiguat NDCs →
Vericiguat side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Vericiguat — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Vericiguat in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Vericiguat FDA approval history
How Vericiguat went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Vericiguat recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Vericiguat recalls since July 2021.
✅No Vericiguat recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 2475830 1 dose form · 3 strengths
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Dose form (SCDF) Oral Tablet RxCUI 2475845In current FDA listings
Look up RxCUI 2475830 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Vericiguat supply and shortage status
Whether Vericiguat is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
💵 What Vericiguat costs pharmacies (NADAC benchmark)
The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.
| Form | Strength | Pharmacy acquisition benchmark | |
|---|---|---|---|
| Tablet, Film Coated · Oral | 2.5 mg | $22.73 per tablet | NDC details & price history |
| Tablet, Film Coated · Oral | 5 mg | $22.73 per tablet | NDC details & price history |
| Tablet, Film Coated · Oral | 10 mg | $22.72 per tablet | NDC details & price history |
Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.
Vericiguat brand names
Vericiguat is sold under one brand name in the FDA directory — Verquvo. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Vericiguat: manufacturers and labelers
One company lists Vericiguat products with the FDA. By number of product records, the largest are Merck Sharp & Dohme LLC. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Vericiguat drug class (RxNorm)
Vericiguat belongs to the Soluble Guanylate Cyclase Stimulator class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Vericiguat page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Merck Sharp & Dohme LLC is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →