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Keep an eye on Intently (one)phenobarbital will lower the extent or effect of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep track of Closely. Coadministration of fentanyl with CYP3A4 inducers could lead into a decrease in fentanyl plasma concentrations, insufficient efficacy or, possibly, advanc