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Monitor Closely (1)pentobarbital will lessen the extent or effect of fentanyl intranasal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Closely. Coadministration of fentanyl with CYP3A4 inducers could lead to some minimize in fentanyl plasma concentrations, lack of efficacy or, possibly, progress of the withd