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Observe Carefully (one)pentobarbital will lessen the extent or influence of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to some lower in fentanyl plasma concentrations, insufficient efficacy or, quite possibly, advanc