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pentobarbital will lower the level or effect of fentanyl intranasal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead on to some lessen in fentanyl plasma concentrations, not enough efficacy or, potentially, development of a withdrawal sy