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Keep an eye on Carefully (1)pentobarbital will lessen the extent or influence of fentanyl by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead into a lessen in fentanyl plasma concentrations, lack of efficacy or, potentially, advancement of a withdrawal