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Keep an eye on Intently (1)pentobarbital will reduce the level or effect of fentanyl transdermal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead to some lessen in fentanyl plasma concentrations, not enough efficacy or, perhaps, enhancement o