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pentobarbital will lower the level or result of tramadol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Keep track of. Reduced AUC of tramadol as well as the active metabolite (O-desmethyltramadol) when coadministered with potent CYP3A4 and CYP2B6 inducerspentobarbital will decrease the extent or outcome of fentanyl transderm