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pentobarbital will lessen the extent or effect of fentanyl intranasal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to a reduce in fentanyl plasma concentrations, not enough efficacy or, perhaps, growth of the withdrawal syndrome in a affect