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Riociguat is a small molecule stimulator of soluble guanylate cyclase (sGC), developed and marketed by Bayer, indicated for the treatment of pulmonary arterial hypertension (PAH, WHO Group 1) and chronic thromboembolic pulmonary hypertension (CTEPH) in adults. It works by sensitizing sGC to endogenous nitric oxide (NO) and directly stimulating sGC independently of NO, leading to increased production of cyclic guanosine monophosphate (cGMP). This results in vasodilation, antiproliferative, and antifibrotic effects that help lower pulmonary blood pressure and improve exercise capacity. Riociguat is the first approved drug from the class of sGC stimulators for both PAH and CTEPH[1][2][3][4][6][8].
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