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Observe Closely (1)pentobarbital will lower the level or influence of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead to some decrease in fentanyl plasma concentrations, insufficient efficacy or, possibly, growth of a withdrawa