<prompt> Phenobarbitone and warfarin interaction results in: March 2005Increased absorption of warfarinIncreased metabolism of warfarinDisplacement of warfarin from the binding siteAll of the above  <response>: Ans. B: Increased metabolism of warfarin Barbiturates increase the metabolism of oral anticoagulants, resulting in reduced anticoagulation effects. If co-administration is unavoidable, monitoring of INR and adjustment of anticoagulant dose is needed. An increase in anticoagulant dose approximately 30-60 may be needed when adding a barbiturate. Withdrawal of barbiturates will result in reduced anticoagulant requirement over several weeks; a reduction in the anticoagulant dose may be needed to prevent bleeding complications 