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Monitor Carefully (one)pentobarbital will lower the extent or result of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Intently. Coadministration of fentanyl with CYP3A4 inducers may lead to some decrease in fentanyl plasma concentrations, deficiency of efficacy or, perhaps, development of a wit