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pentobarbital will reduce the extent or influence of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Watch.pentobarbital will decrease the extent or effect of tramadol by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Watch. Lessened AUC of tramadol and also the Energetic metabolite (O-desmeth