Summary
The administration of phenobarbital or glutethimide significantly decreased the half-life
of warfarin in 21 of 34 hospitalized patients. Patients who demonstrated a decrease
could not be distinguished from apparent non-responders by age, weight, sex, or race.
These sedatives did not detectably affect gastrointestinal absorption of warfarin.
The observed decrease in warfarin half-life supports the concept that barbiturates
and other drugs can increase the concentration of some drug-metabolizing enzymes.
Since anticoagulating activity of coumarins is related to drug half-life, it is suggested
that barbiturates or glutethimide therapy be discontinued in patients who appear refractory
to anticoagulation with coumarins.