New Research Indicates Simplified Dosing for Heart Failure Medications is Safe

A recent study presented at the 2025 European Society of Cardiology Heart Failure conference suggests that the standard dosing process for certain heart failure medications can be safely streamlined. Heart failure with reduced ejection fraction affects approximately 32 million people worldwide, and managing medication titration remains a clinical challenge. Traditionally, patients start on a low dose of medications like vericiguat and gradually increase to target levels through multiple steps, a process that can be hindered by clinical inertia, resulting in suboptimal treatment, increased risk of hospitalizations, and higher mortality rates.

The study, led by researchers from Duke University and featuring 106 patients across seven countries, tested initiating vericiguat at a 5 mg dose—double the recommended starting dose of 2.5 mg—over a two-week period. The findings demonstrated that most patients tolerated the higher initial dose well, with safety profiles comparable to traditional dosing. Over 90% of participants successfully tolerated the higher starting dose, and no significant safety concerns were observed.

Stephen Greene, M.D., the lead author, emphasized that simplifying the initiation process could reduce barriers to effective therapy. "In real-world practice, many patients never reach optimal medication doses despite multiple visits and adjustments. Reducing the number of titration steps may improve medication adherence and help patients achieve better outcomes."

This approach not only simplifies the process for clinicians but also addresses logistical challenges in busy clinical settings. Greene stated that making medication initiation more straightforward could help overcome clinical inertia and enhance the quality of care for heart failure patients.

Overall, this study suggests that starting vericiguat at 5 mg is a safe and effective strategy that can accelerate reaching target doses, potentially improving patient outcomes and reducing treatment gaps. Further research may confirm whether this simplified approach can be generalized to other heart failure medications.

Source: Medical Xpress