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Keep an eye on Carefully (1)pentobarbital will reduce the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to your lessen in fentanyl plasma concentrations, deficiency of efficacy or, potentially, growth