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Check Intently (1)phenobarbital will reduce the extent or impact of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with CYP3A4 inducers may lead to a reduce in fentanyl plasma concentrations, deficiency of efficacy or, possibly, advancement of a withdrawal