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Keep track of Intently (1)phenobarbital will decrease the extent or outcome of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Check Closely. Coadministration of fentanyl with CYP3A4 inducers may lead to some lower in fentanyl plasma concentrations, insufficient efficacy or, possibly, development of th