Verquvo (vericiguat) is a prescription drug that helps prevent certain complications in adults with symptomatic heart failure. Verquvo comes as a tablet that you swallow.

Verquvo is used in adults with symptomatic heart failure and a reduced ejection fraction who have been previously:

Doctors prescribe Verquvo to decrease the risk of cardiovascular (heart and blood vessel) death and future hospitalization for heart failure.

To learn more about Verquvo’s uses, see the “What is Verquvo used for?” section below.

* IV medications are injected into a vein.

Verquvo basics

Verquvo is a brand-name medication. It contains the active ingredient vericiguat. (An active ingredient is what makes a drug work.) A generic version of the drug isn’t available.

Like most drugs, Verquvo may cause mild or serious side effects. The lists below describe some of the more common side effects that Verquvo may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Verquvo. They can also suggest ways to help reduce side effects.

Mild side effects

Verquvo may cause a mild allergic reaction. To learn more about this side effect, see the “Allergic reaction” section below.

No other mild side effects were reported during studies of Verquvo. Talk with your doctor or pharmacist if you’re having symptoms that you think may be side effects of Verquvo.

Serious side effects

Serious side effects from Verquvo can occur, but they aren’t common.

If you have serious side effects from Verquvo, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Verquvo that have been reported include:

* For more information, see the “What should be considered before taking Verquvo?” section.
† To learn more about this side effect, see the “Allergic reaction” section below.

Allergic reaction

While allergic reaction wasn’t reported in studies of Verquvo, it can still happen.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Verquvo. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Other drugs are available that can treat your condition. If you’d like to explore an alternative to Verquvo, talk with your doctor. They can tell you about other medications that might work well for you.

Verquvo is the only drug that works the way it does to reduce the risk of complications from heart failure. But the following drugs are prescribed for similar uses:

Find answers to some commonly asked questions about Verquvo.

How does Verquvo work?

Verquvo activates an enzyme (a type of protein) that helps to relax blood vessels.

Soluble guanylate cyclase (sGC) is an enzyme that’s important for managing your body’s blood pressure. Usually sGC is activated by nitric oxide (NO), a substance found naturally in the body. When activated, sGC causes blood vessels to relax. It’s easier for the heart to pump blood into relaxed blood vessels.

Verquvo belongs to a group of drugs called sGC stimulators. Its mechanism of action is to directly activate the sGC enzyme. It also makes sGC more sensitive to activation by NO.

By activating sGC, Verquvo helps the blood vessels to relax and widen, making it easier for the heart to pump blood.

If you’d like to learn more about how Verquvo works, talk with your doctor or pharmacist.

How does Verquvo compare with Entresto?

Both Verquvo and Entresto are oral tablets taken to prevent complications of heart failure. Verquvo is taken once daily, and Entresto is taken twice daily.

Verquvo can be prescribed for adults, but Entresto can be prescribed for adults and for children ages 1 year and older. Neither drug is safe to take if you’re pregnant or breastfeeding.

Entresto contains two active ingredients, sacubitril and valsartan. Verquvo contains a single active ingredient, vericiguat. They each belong to a different group of drugs.

Entresto and Verquvo interact with different drugs. For example, Entresto interacts with angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril). But Verquvo can safely be taken with an ACE inhibitor.

If you have other questions about how Verquvo and Entresto compare, talk with your doctor. They can help you find the best treatment for you.

Verquvo is used to help reduce the risks of cardiovascular (heart and blood vessel) death and hospitalization for heart failure. It’s prescribed for adults who have symptomatic heart failure and a low ejection fraction (EF).

With heart failure, your heart doesn’t pump blood efficiently. The heart muscles either don’t contract well or are too stiff. With symptomatic heart failure, you may experience symptoms such as tiredness, shortness of breath, and edema (swelling).

With each heartbeat, blood is squeezed out of the heart chamber called the left ventricle (LV) and into the blood vessels in your body. The EF measures the percentage of blood your heart squeezes out with each beat. In a healthy heart, the LV usually squeezes out at least half of the blood in its chamber with each beat. Verquvo may be prescribed when this percentage decreases to less than 45%.

Your doctor may decide to prescribe Verquvo for you after you’ve been in the hospital for heart failure complications. Complications include congestive heart failure, abnormal heart rhythms, and stroke. They may also prescribe Verquvo if you’ve needed intravenous (IV) diuretic medications to remove excess fluid from your body.

To learn more about Verquvo’s uses, talk with your doctor.

Whether you have health insurance or not, cost may be a factor when you’re considering Verquvo. What you’ll pay for Verquvo may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks* to get price estimates of what you’d pay for Verquvo when using coupons from the site.
  • Savings programs and manufacturer coupons: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You may be eligible for a coupon from the drug’s manufacturer.

You can also check out this article to learn more about saving money on prescriptions.

* Optum Perks is a sister site of Healthline. Optum Perks coupons cannot be used with any insurance copays or benefits.

Your doctor will recommend the dosage of Verquvo that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

Verquvo is available as an oral tablet in three strengths: 2.5 milligrams (mg), 5 mg, and 10 mg.

Recommended dosages

When you first start taking Verquvo, your doctor will likely prescribe a dose of 2.5 mg to be taken once per day. This is the usual starting dosage.

Every 2 weeks, depending on your blood pressure and heart failure symptoms, your doctor will double your dosage until you reach the maintenance dosage of 10 mg once per day.

How to take

Your doctor will explain how you should take Verquvo. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Questions about taking Verquvo

Below are some common questions about taking Verquvo.

  • Can Verquvo be chewed, crushed, or split? Yes. If you have trouble swallowing pills, you may crush Verquvo tablets. Mix the crushed tablet into water right before you need to take it and drink the mixture. Talk with your doctor to learn more.
  • Should I take Verquvo with food? Yes. Verquvo should always be taken with food. Taking Verquvo with food helps your body absorb the drug.
  • Is there a best time of day to take Verquvo? Verquvo can be taken at any time of day, but it’s best to take it around the same time each day. This helps keep a consistent level of the drug in your body, which helps Verquvo work effectively.
  • What if I miss a dose of Verquvo? If you miss a dose of Verquvo, take it as soon as you remember. But if it’s almost time to take your next dose, skip the missed dose and take the next dose at its usual time. You should not take two doses at once to make up for a missed dose. Doing so could raise your risk of side effects.
  • Will I need to use Verquvo long term? Yes, you’ll likely take Verquvo long term. This drug helps prevent complications from chronic heart failure, which is a long-term condition. So if Verquvo works for you, your doctor will likely recommend taking it long term.
  • How long does Verquvo take to work? Verquvo starts working after you take your first dose. But you won’t likely feel the drug working.

Overdose

Do not take more Verquvo than your doctor prescribes. Using more than this can lead to harmful effects.

Symptoms of overdose

Taking too much Verquvo could cause you to have low blood pressure. Symptoms of low blood pressure include:

Very low blood pressure may also cause loss of consciousness.

What to do in case you take too much Verquvo

Call your doctor if you think you’ve taken too much Verquvo. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Below is important information you should consider before taking Verquvo.

Interactions

Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

Verquvo can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Before taking Verquvo, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Drug interactions

Below is a list of medications that can interact with Verquvo. This list does not contain all drugs that may interact with Verquvo. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drug group or drug nameDrug examples
phosphodiesterase type 5 (PDE5) inhibitors• sildenafil (Viagra)
• tadalafil (Cialis)
• vardenafil (Levitra)
riociguat (Adempas)—

Verquvo and alcohol

Alcohol is not known to interact with Verquvo. However, excessive* drinking can damage and weaken the heart muscle over time.

If you drink alcohol, talk with your doctor about how much is safe to drink while you’re taking Verquvo.

* According to the Centers for Disease Control (CDC), excessive alcohol use includes binge drinking (consuming 4 or more drinks on an occasion for a woman and 5 or more drinks on an occasion for a man) and heavy drinking (defined as 8 or more drinks per week for a woman and 15 or more drinks per week for a man).

Pregnancy and breastfeeding

Your doctor will recommend that you do not take Verquvo during pregnancy or while breastfeeding.

Verquvo is not safe to use during pregnancy. To learn more, see “Boxed warnings: Risk of fetal harm” below.

Verquvo may pass into breast milk. It’s not known what effects Verquvo might have on a child who is breastfed. To be safe, your doctor will recommend that you not breastfeed while taking Verquvo.

Boxed warnings: Risk of fetal harm

Verquvo has a boxed warning about the risk of fetal harm. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

In animal studies, vericiguat, the active ingredient in Verquvo, caused cardiovascular (heart and blood vessel) birth defects and miscarriage. Animal studies don’t always reflect what will happen in humans. It’s not known if Verquvo causes birth defects or miscarriage in humans.

To be safe, doctors will not prescribe Verquvo if you’re pregnant or planning to become pregnant. If you have questions about Verquvo and the risk of fetal harm, talk with your doctor.

Birth control

If you’re able to become pregnant, you should use birth control throughout your Verquvo treatment and for at least 1 month after your last dose.

If you do become pregnant while taking Verquvo, consider enrolling in the drug’s pregnancy surveillance program. This program collects information about the effect of Verquvo on pregnancy outcomes.

Other warnings

Verquvo can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Verquvo is a good treatment option for you.

Talk with your doctor about your health history before you take Verquvo. Be sure to tell them if any of the following factors apply to you:

If you have questions about taking Verquvo, talk with your doctor or pharmacist. Questions you may want to ask include:

  • How long should I expect to take Verquvo?
  • How will you decide if my dosage should be increased?
  • Are there any over-the-counter (OTC) or herbal supplements I should avoid while taking Verquvo?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.