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Keep track of Carefully (1)pentobarbital will reduce the extent or outcome of fentanyl transdermal 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, probably, improvement