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pentobarbital will lessen the extent or effect of fentanyl intranasal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead on to a minimize in fentanyl plasma concentrations, lack of efficacy or, quite possibly, growth of a withdrawal syndrome inside