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Watch Closely (1)pentobarbital will lessen the extent or influence of fentanyl by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to the decrease in fentanyl plasma concentrations, insufficient efficacy or, perhaps, enhancement of a withdrawal sy