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pentobarbital will reduce the extent or influence of methadone by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pentobarbital will reduce the extent or influence of tramadol by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Monitor. Lessened AUC of tramadol along with the Lively metabolite (O-desme