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Monitor Carefully (1)phenobarbital will lower the level or impact of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Intently. Coadministration of fentanyl with CYP3A4 inducers could lead on to a reduce in fentanyl plasma concentrations, not enough efficacy or, probably, progress of a wit