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Keep an eye on Carefully (1)phenobarbital will decrease the extent or effect of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Closely. Coadministration of fentanyl with CYP3A4 inducers could lead on to a lower in fentanyl plasma concentrations, insufficient efficacy or, maybe, growth of the wit