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Observe Closely (1)pentobarbital will lessen the level or outcome of fentanyl transdermal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Closely. Coadministration of fentanyl with CYP3A4 inducers could lead to a minimize in fentanyl plasma concentrations, lack of efficacy or, potentially, progress of the withdrawal