Verquvo Special Precautions

Symptomatic Hypotension: Vericiguat (Verquvo) may cause symptomatic hypotension. In the VICTORIA clinical trial, adverse events determined by the investigator to be events of symptomatic hypotension were reported in 9.1% of patients treated with Vericiguat (Verquvo) and 7.9% of patients treated with placebo and were considered serious in 1.2% of patients treated with Vericiguat (Verquvo) and 1.5% of patients treated with placebo [see Clinical Trials Experience under Adverse Reactions]. Vericiguat (Verquvo) has not been studied in patients with systolic blood pressure less than 100 mmHg or symptomatic hypotension at treatment initiation.
Consider the potential for symptomatic hypotension in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, history of hypotension, or concomitant treatment with antihypertensives or organic nitrates [see Pharmacology: Drug Interaction Studies under Actions]. If symptomatic hypotension occurs, consider dose adjustment of diuretics and treatment of other causes of hypotension (e.g., hypovolemia). If symptomatic hypotension persists despite such measures, temporary reduction in dose or interruption of Vericiguat (Verquvo) should be considered.
Concomitant use of Vericiguat (Verquvo) and phosphodiesterase-5 (PDE-5) inhibitors, such as sildenafil, has not been studied in patients with heart failure and is therefore not recommended due to the potential increased risk for symptomatic hypotension [see PDE-5 Inhibitors under Interactions and Pharmacology: Drug Interaction Studies under Actions].
Renal Impairment: No dose adjustment of Vericiguat (Verquvo) is required in patients with eGFR ≥15 mL/min/1.73m² (without dialysis). Vericiguat (Verquvo) has not been studied in patients with eGFR <15 mL/min/1.73m² at treatment initiation or on dialysis and is therefore not recommended in these patients [see Renal Impairment under Dosage & Administration, Pharmacology: Pharmacodynamics: Clinical Studies and Pharmacokinetics under Actions].
Hepatic Impairment: No dose adjustment of Vericiguat (Verquvo) is required in patients with mild or moderate hepatic impairment. Vericiguat (Verquvo) has not been studied in patients with severe hepatic impairment and is therefore not recommended in these patients [see Hepatic Impairment under Dosage & Administration and Pharmacology: Pharmacokinetics under Actions].
Use in Pregnancy & Lactation: See Use in Pregnancy & Lactation section for further information.
Use in Children: Safety and efficacy of Vericiguat (Verquvo) have not been established in patients less than 18 years of age.
Use in the Elderly: No dosage adjustment of Vericiguat (Verquvo) is required in geriatric patients. In VICTORIA, a total of 1,596 (63%) patients treated with Vericiguat (Verquvo) were 65 years and older and 783 (31%) patients treated with Vericiguat (Verquvo) were 75 years and older. No overall differences in safety or efficacy of Vericiguat (Verquvo) were observed between patients aged 65 years and older compared to younger patients, but greater sensitivity of some older individuals cannot be ruled out [see Pharmacology: Pharmacodynamics: Clinical Studies and Pharmacokinetics under Actions].