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Watch Intently (1)pentobarbital will decrease the level or influence of fentanyl transdermal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead into a lessen in fentanyl plasma concentrations, insufficient efficacy or, possibly, advancement of the