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Monitor Closely (one)phenobarbital will lessen the extent or effect of fentanyl transmucosal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to your reduce in fentanyl plasma concentrations, insufficient efficacy or, possibly, enhancement of