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Check Closely (1)pentobarbital will decrease the extent or effect of fentanyl intranasal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead to the decrease in fentanyl plasma concentrations, deficiency of efficacy or, probably, progress of a wi