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Keep an eye on Closely (1)pentobarbital will lower the level or impact of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on into a reduce in fentanyl plasma concentrations, lack of efficacy or, potentially, growth of a withdrawal s