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pentobarbital will lessen the extent or impact of doxorubicin by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Check.pentobarbital will lessen the level or effect of tramadol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Keep track of. Decreased AUC of tramadol as well as the active metabolite (O-desme