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Keep track of Carefully (1)phenobarbital will minimize the level or result of fentanyl transmucosal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead on to the decrease in fentanyl plasma concentrations, deficiency of efficacy or, quite possibly,