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Watch Carefully (1)pentobarbital will decrease the extent or influence of fentanyl transdermal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead to a minimize in fentanyl plasma concentrations, not enough efficacy or, possibly, development of the wi