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Watch Carefully (1)pentobarbital will minimize the extent or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Closely. Coadministration of fentanyl with CYP3A4 inducers may lead to a lessen in fentanyl plasma concentrations, insufficient efficacy or, possibly, growth of the withdrawal synd