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Monitor Intently (1)pentobarbital will reduce the extent or impact of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Intently. Coadministration of fentanyl with CYP3A4 inducers could lead to a lower in fentanyl plasma concentrations, insufficient efficacy or, potentially, enhancement of the with