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Observe Carefully (1)pentobarbital will lessen the extent or outcome of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead on to some minimize in fentanyl plasma concentrations, not enough efficacy or, potentially, improvement