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pentobarbital will reduce the extent or impact of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Stay away from or Use Alternate Drug. Netupitant is especially metabolized by CYP3A4; prevent use in individuals that are chronically employing a solid CYP3A4 inducerCaution is warranted for people with renal and hepat