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pentobarbital will decrease the extent or effect of netupitant/palonosetron by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Steer clear of or Use Alternate Drug. Netupitant is especially metabolized by CYP3A4; steer clear of use in clients who will be chronically applying a strong CYP3A4 inducerAlthough it can be employed like a sedativ