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Monitor Closely (one)phenobarbital will minimize the level or influence of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Intently. Coadministration of fentanyl with CYP3A4 inducers may lead to some reduce in fentanyl plasma concentrations, not enough efficacy or, maybe, improvement of a withd