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Keep an eye on Intently (1)pentobarbital will lessen the extent or impact of fentanyl transmucosal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on to a reduce in fentanyl plasma concentrations, insufficient efficacy or, quite possibly, improvem