Table of Contents

Introduction
Pharmacology
Examples

soluble guanylate cyclase stimulators

see also:

heart failure with reduced ejection fraction (HFrEF)

Introduction

soluble guanylate cyclase stimulators are a class of therapeutic agents that increase intracellular cyclic GMP (cGMP) levels, leading to smooth muscle relaxation and improved blood flow by targeting the nitric oxide-sGC-cGMP pathway via directly stimulating the sGC enzyme independently of nitric oxide (NO) and sensitize sGC to existing NO

should not be used in combination with phosphodiesterase-V (PDE5) inhibitors (such as sildenafil) due to the risk of severe hypotension

Pharmacology

directly stimulating the sGC enzyme independently of nitric oxide (NO) and sensitize sGC to existing NO leading to smooth muscle relaxation and vasodilatation
act specifically on the reduced (ferrous) heme group of the sGC enzyme, separating them from “sGC activators” which target oxidized or heme-free enzymes
potential side effects include hypotension, dizziness, and gastrointestinal issues

Examples

vericiguat
- used in heart failure with reduced ejection fraction (HFrEF)
riociguat
- used in pulmonary HT