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Monitor Carefully (1)pentobarbital will decrease the level or result of fentanyl transdermal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with CYP3A4 inducers could lead to your reduce in fentanyl plasma concentrations, lack of efficacy or, possibly, growth of a withdrawal