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Watch Intently (one)pentobarbital will lower the extent or effect of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Intently. Coadministration of fentanyl with CYP3A4 inducers could lead to a minimize in fentanyl plasma concentrations, deficiency of efficacy or, potentially, progress of a withdra