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Observe Closely (one)pentobarbital will decrease the level or effect of fentanyl intranasal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead on to some lower in fentanyl plasma concentrations, not enough efficacy or, perhaps, progress of a