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Watch Closely (one)pentobarbital will reduce the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead to a reduce in fentanyl plasma concentrations, deficiency of efficacy or, probably, enhancement of the with