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Keep track of Carefully (one)phenobarbital will lower the level or influence of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Carefully. Coadministration of fentanyl with CYP3A4 inducers may lead to the minimize in fentanyl plasma concentrations, lack of efficacy or, perhaps, progress of a wi