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Keep track of Carefully (1)phenobarbital will lower the level or result of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to the minimize in fentanyl plasma concentrations, not enough efficacy or, possibly, improvement of