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Check Intently (1)phenobarbital will lessen the extent or effect of fentanyl transmucosal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Watch Intently. Coadministration of fentanyl with CYP3A4 inducers may lead to a reduce in fentanyl plasma concentrations, lack of efficacy or, maybe, growth of a withdrawal syndrome ins