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Vericiguat oral suspension (Formulation 4) is a specific pediatric liquid formulation of vericiguat (BAY 1021189) developed by Bayer. This particular formulation is characterized by increased levels of sucralose and flavoring agents compared to other test versions, designed to optimize palatability for children. Vericiguat is a small molecule stimulator of soluble guanylate cyclase (sGC), an enzyme in the nitric oxide (NO) signaling pathway. It works by directly stimulating sGC independently of NO and sensitizing the enzyme to endogenous NO, thereby increasing levels of cyclic guanosine monophosphate (cGMP). Elevated cGMP leads to smooth muscle relaxation and vasodilation, which helps improve cardiac function and reduce myocardial stiffness. While vericiguat is approved in tablet form (Verquvo) for adults with symptomatic chronic heart failure and reduced ejection fraction (HFrEF), this oral suspension is being evaluated for use in pediatric heart failure patients.
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