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Watch Closely (one)pentobarbital will reduce the extent or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on to some lessen in fentanyl plasma concentrations, insufficient efficacy or, probably, growth of the withdrawa