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Keep an eye on Closely (one)pentobarbital will decrease the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to some decrease in fentanyl plasma concentrations, lack of efficacy or, perhaps, development of the withdraw