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Watch Carefully (1)pentobarbital will reduce the level or outcome of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on to a lessen in fentanyl plasma concentrations, insufficient efficacy or, potentially, growth of a w