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pentobarbital will decrease the level or effect of netupitant/palonosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stay clear of or Use Alternate Drug. Netupitant is mainly metabolized by CYP3A4; prevent use in individuals who are chronically employing a solid CYP3A4 inducerpentobarbital will lower the level or impact of ixabepilo