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Keep an eye on Closely (1)pentobarbital will lower the extent or influence of fentanyl transdermal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead to some decrease in fentanyl plasma concentrations, insufficient efficacy or, possibly, improvement of