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Check Closely (1)pentobarbital will lessen the level or impact of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Intently. Coadministration of fentanyl with CYP3A4 inducers may lead to some lower in fentanyl plasma concentrations, deficiency of efficacy or, potentially, improvement of the