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pentobarbital will lower the extent or impact of netupitant/palonosetron by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Netupitant is principally metabolized by CYP3A4; avoid use in individuals who are chronically utilizing a robust CYP3A4 inducerPentobarbital can result in drowsiness and impair psychologic