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Monitor Closely (one)pentobarbital will lower the level or influence of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Intently. Coadministration of fentanyl with CYP3A4 inducers could lead to the lower in fentanyl plasma concentrations, lack of efficacy or, possibly, enhancement of a wit