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Observe Closely (one)phenobarbital will decrease the extent or influence of fentanyl transmucosal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Intently. Coadministration of fentanyl with CYP3A4 inducers could lead to the lower in fentanyl plasma concentrations, not enough efficacy or, quite possibly, enhancement