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Watch Closely (1)pentobarbital will minimize the extent or impact of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on to the reduce in fentanyl plasma concentrations, lack of efficacy or, potentially, growth of a withdrawal