Following xenobiotic exposure, enzyme induction and its associated hepatocellular hypertrophy are not usually immediately apparent, with a maximal response occurring a few days to a week or more after exposure, since the enzyme inducer must first reach steady state, and new drug-metabolizing enzymes need to be synthesized
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Skipping dose levels (e.g., jumping from 0.6 mg to 1.8 mg) should be avoided, as this significantly increases the risk of adverse events
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This results in B12 malabsorption, deficiency, and megaloblastic (abnormally large and dysfunctional) RBCs in many cases
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