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Keep track of Carefully (1)pentobarbital will minimize the level or outcome of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Carefully. Coadministration of fentanyl with CYP3A4 inducers could lead to a lessen in fentanyl plasma concentrations, not enough efficacy or, possibly, growth of the withdrawal syndrome in a very affected person who's got developed physical dependence to fentanyl. Just after stopping a CYP3A4 inducer, as the consequences from the inducer decrease, the fentanyl plasma focus will raise which could improve or prolong the two the therapeutic and adverse outcomes.

pentobarbital improves toxicity of buprenorphine, lengthy-performing injection by pharmacodynamic synergism. Modify Therapy/Watch Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases hazard of adverse reactions together with overdose, respiratory depression, and Demise. Cessation of benzodiazepines or other CNS depressants is preferred typically.

fentanyl transmucosal and pentobarbital each increase sedation. Prevent or Use Alternate Drug. Restrict use to clients for whom alternative remedy alternatives are insufficient

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