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Observe Carefully (one)phenobarbital will lower the level or effect of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead to a reduce in fentanyl plasma concentrations, not enough efficacy or, potentially, growth of a w