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pentobarbital will lower the extent or influence of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Use Warning/Watch.pentobarbital will decrease the level or effect of tramadol by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Watch. Reduced AUC of tramadol and also the active metabolite (O-desmethyltramadol) when c