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pentobarbital will reduce the level or influence of etoposide by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Keep an eye on.pentobarbital will reduce the level or outcome of tramadol by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Keep track of. Reduced AUC of tramadol and the Energetic metabolite (O