Product image of Midive (Riociguat) supplied by GNH India

Midive

Active Ingredient:
Riociguat
Origin:
EU

Midive (Riociguat)

Riociguat, the active ingredient in Midive, is a soluble guanylate cyclase stimulator presented as an oral tablet for oral use. It is indicated for the treatment of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension in adult patients. The medication is formulated for systemic absorption and is part of the therapeutic options for patients with elevated pulmonary vascular resistance.

GNH India supplies Midive as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide, with a focus on quality assurance, regulatory compliance and reliable logistics across multiple continents.

Manufacturer / TM Owner

Adalvo Limited

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Indications & Clinical Uses

  • Midive (riociguat) is used in the management of diseases affecting the pulmonary vasculature.
  • Pulmonary arterial hypertension: improves exercise capacity and delays disease progression.
  • Chronic thromboembolic pulmonary hypertension: enhances hemodynamic parameters and functional class.
  • Inoperable chronic thromboembolic pulmonary hypertension: provides a medical option when surgical intervention is not feasible.

How It Works

  • Riociguat stimulates soluble guanylate cyclase, the enzyme that converts guanosine triphosphate to cyclic GMP. Increased cyclic GMP leads to relaxation of smooth muscle cells in the pulmonary arteries, producing vasodilation and reducing pulmonary vascular resistance, thereby improving blood flow through the lungs.

Side Effects

Riociguat may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

  • Headache
  • Dizziness
  • Nausea
  • Diarrhea
  • Dyspepsia
  • Mild hypotension

Serious or Rare Side Effects

  • Severe hypotension or syncope
  • Pulmonary hemorrhage or hemoptysis
  • Liver enzyme elevation
  • Anemia or other hematologic abnormalities
  • Pulmonary edema

Precautions & Warnings

Before initiating therapy, clinicians should evaluate patient-specific risk factors and monitor for potential complications.

  • Blood pressure monitoring: check baseline and regularly during treatment.
  • Concomitant nitrates: avoid due to additive hypotensive effect.
  • Hepatic function: assess liver enzymes before and during therapy.
  • Renal impairment: adjust use in severe renal dysfunction.
  • Pregnancy: safety not established; avoid use in pregnant women.
  • Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Avoid Interactions

Riociguat can interact with several drug classes, requiring careful management.

Major Interactions (Avoid)

  • Nitrates (e.g., nitroglycerin): risk of profound hypotension.
  • Phosphodiesterase‑5 inhibitors (e.g., sildenafil): additive vasodilatory effect.
  • Strong CYP3A4 inhibitors (e.g., ketoconazole): may increase riociguat exposure.

Moderate Interactions (Monitor Closely)

  • Antihypertensive agents: may enhance blood‑pressure lowering.
  • Anticoagulants/antiplatelets: monitor for bleeding.
  • Diuretics: watch for electrolyte disturbances and volume depletion.

Frequently Asked Questions

Midive, containing riociguat, is prescribed for adults with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension, helping to lower pulmonary artery pressure and improve exercise capacity.

Riociguat activates soluble guanylate cyclase, increasing cyclic GMP levels. Elevated cyclic GMP relaxes pulmonary arterial smooth muscle, causing vasodilation and reducing resistance in the lung circulation.

The dose of Midive is individualized by the prescribing physician based on clinical response, blood‑pressure measurements, and tolerability. Patients should follow the prescriber’s specific instructions.

Safety of riociguat in pregnancy or while nursing has not been established. It should be avoided in pregnant women and used with caution in breastfeeding mothers, following a physician’s assessment.

To request Midive, submit an enquiry on the product page at gnhindia.com, specifying the required quantity. GNH India works with hospitals, pharmacies and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details and any necessary import documentation.

Riociguat belongs to the soluble guanylate cyclase stimulator class, offering a distinct mechanism from endothelin‑receptor antagonists and phosphodiesterase‑5 inhibitors. It may be chosen when patients need an alternative pathway to achieve pulmonary vasodilation.

Midive should be stored at room temperature, below 25 °C, in its original container, protected from moisture and direct sunlight to maintain stability.

Midive is taken orally, usually as a tablet, with or without food as directed by the healthcare provider. Swallow the tablet whole with water.

Serious risks include severe hypotension, pulmonary hemorrhage, liver enzyme elevation, and rare cases of pulmonary edema. Patients should be monitored for these events and report any concerning symptoms promptly.

Midive is contraindicated in patients taking nitrates, those with severe hepatic impairment, and individuals with known hypersensitivity to riociguat or any of its excipients. It should also be avoided in pregnancy until safety is established.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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