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Keep an eye on Intently (1)pentobarbital will lower the extent or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead into a decrease in fentanyl plasma concentrations, insufficient efficacy or, probably, development of t