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pentobarbital will reduce the level or result of pioglitazone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Importance Unfamiliar.pentobarbital will lessen the extent or outcome of naloxegol by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Usage of naloxegol with powerful CYP3A4 inducers is not advisableB