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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/Keep an eye on Intently. Coadministration of fentanyl with CYP3A4 inducers could lead into a reduce in fentanyl plasma concentrations, not enough efficacy or, probably, progress of