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Keep an eye on Closely (one)pentobarbital will decrease the extent or influence of fentanyl intranasal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on to the lessen in fentanyl plasma concentrations, deficiency of efficacy or, maybe, development