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Watch Closely (one)pentobarbital will lessen the level or effect of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Intently. Coadministration of fentanyl with CYP3A4 inducers may lead into a reduce in fentanyl plasma concentrations, lack of efficacy or, possibly, improvement of a withdrawal sy