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pentobarbital decreases amounts of toremifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Monitor. CYP3A4 inducers raise price of toremifene metabolism, decreasing the regular-point out concentration in serum.pentobarbital will lessen the extent or effect of midostaurin by impacting hepatic/intestinal enzyme CYP3A4 metabol