Riociguat
Riociguat is a soluble guanylate cyclase (sGC) stimulator used to treat pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). It works by directly stimulating sGC, increasing cyclic GMP (cGMP) levels, which promotes vasodilation and improves blood flow in the pulmonary arteries. This medication is typically prescribed for patients with WHO functional class II-III symptoms who require treatment to improve exercise capacity and hemodynamics.
Riociguat is a pulmonary hypertension medication that directly stimulates an enzyme to increase cGMP, promoting blood vessel dilation and improved pulmonary blood flow.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- C02KX05
- RxNorm
- 1439816
- Generic
- Riociguat
- Class
- atc-c02
- Brands
- Adempas
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Treatment of pulmonary arterial hypertension (PAH) in adults with WHO functional class II-III symptoms to improve exercise capacity and hemodynamic parameters, and treatment of chronic thromboembolic pulmonary hypertension (CTEPH) in adults with WHO functional class II-III who remain symptomatic after surgery or cannot undergo surgery.
Riociguat directly stimulates soluble guanylate cyclase (sGC), an enzyme in the cardiopulmonary system that is the receptor for nitric oxide (NO). By binding to sGC independently of NO, it increases intracellular cyclic guanosine monophosphate (cGMP) levels, leading to smooth muscle relaxation, vasodilation, and improved pulmonary blood flow.
Contraindicated in pregnancy, concurrent use with nitrates or PDE5 inhibitors due to risk of severe hypotension. Requires regular blood pressure monitoring, especially during initiation and dose titration. Not recommended in patients with severe hepatic or renal impairment. Must be discontinued if pregnancy occurs. Tablets are taken three times daily with or without food, avoiding grapefruit juice.
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy