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pentobarbital will minimize the level or influence of fentanyl intranasal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Intently. Coadministration of fentanyl with CYP3A4 inducers could lead to your lessen in fentanyl plasma concentrations, lack of efficacy or, possibly, progress of a withdrawal syndrome