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Check Intently (one)pentobarbital will lower the level or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead on into a reduce in fentanyl plasma concentrations, deficiency of efficacy or, probably, advancement of a withd