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Watch Closely (1)pentobarbital will lessen the extent or impact of fentanyl transmucosal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to some lessen in fentanyl plasma concentrations, insufficient efficacy or, perhaps, development of a with