D->R->C + R

D->R->C + R is a specific clinical trial treatment regimen consisting of the sequential and concurrent administration of the direct oral anticoagulants (DOACs) **dabigatran etexilate** and **rivaroxaban**, along with the macrolide antibiotic **clarithromycin**. This regimen was evaluated by **Assistance Publique - Hôpitaux de Paris** in the Phase 1 **DRIVING** (Genetics and Anticoagulants) study to investigate the influence of genetic polymorphisms, particularly in the **ABCB1** gene (encoding the P-glycoprotein efflux transporter), on the intestinal absorption and pharmacokinetics of these anticoagulants. Dabigatran etexilate acts as a direct thrombin inhibitor, while rivaroxaban is a direct factor Xa inhibitor; both are primarily indicated for the prevention and treatment of **thromboembolism**. Clarithromycin is utilized in this context as a potent inhibitor of both **P-glycoprotein** and the **CYP3A4** enzyme to assess drug-drug interactions and the role of transporter genetics in drug exposure.

Brand names

PradaxaXareltoBiaxin

Other names

D->R->C + R-Assistance Publique - Hôpitaux de Paris-thromboembolismdabigatran etexilate + rivaroxaban + clarithromycinDRIVING trial regimen