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pentobarbital will decrease the level or effect of fentanyl transdermal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Intently. Coadministration of fentanyl with CYP3A4 inducers may lead into a lower in fentanyl plasma concentrations, lack of efficacy or, perhaps, advancement of a withdrawal syndrome inside a affe