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Watch Intently (1)phenobarbital will reduce the level or effect of fentanyl transmucosal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead to the reduce in fentanyl plasma concentrations, not enough efficacy or, perhaps, progress of a withdrawal