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Watch Carefully (1)pentobarbital will lower the level or outcome of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead to a minimize in fentanyl plasma concentrations, deficiency of efficacy or, perhaps, improvement of