by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.cevimelineMinor (1)pentobarbital will decrease the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.chloral hydrateMonitor Closely (1)pentobarbital and chloral hydrate both increase sedation. Use Caution/Monitor.chloramphenicolMonitor Closely (1)chloramphenicol increases levels of pentobarbital by decreasing metabolism. Use Caution/Monitor.Minor (1)pentobarbital decreases levels of chloramphenicol by increasing metabolism. Minor/Significance Unknown.chlordiazepoxideMonitor Closely (1)pentobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.chlorpheniramineMonitor Closely (1)chlorpheniramine and pentobarbital both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (1)pentobarbital and chlorpromazine both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital decreases levels of chlorpromazine by increasing metabolism. Minor/Significance Unknown.chlorzoxazoneMonitor Closely (1)pentobarbital and chlorzoxazone both increase sedation. Use Caution/Monitor.cilostazolMonitor Closely (1)pentobarbital will decrease the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cimetidineMinor (1)pentobarbital will decrease the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.cinacalcetMonitor Closely (1)pentobarbital will decrease the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and pentobarbital both increase sedation. Use Caution/Monitor.clarithromycinMinor (2)pentobarbital will decrease the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. pentobarbital decreases levels of clarithromycin by increasing elimination. Minor/Significance Unknown.clemastineMonitor Closely (1)clemastine and pentobarbital both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (1)pentobarbital, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineMonitor Closely (3)pentobarbital will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. pentobarbital will decrease the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. pentobarbital and clomipramine both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital, clomipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.clonazepamMonitor Closely (1)pentobarbital and clonazepam both increase sedation. Use Caution/Monitor.clopidogrelMonitor Closely (1)pentobarbital will increase the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inducers may increase the metabolism of clopidogrel to its active metabolite. Monitor patients for potential increase in antiplatelet effects when CYP3A4 inducers are used in combination with clopidogrelclorazepateMonitor Closely (1)pentobarbital and clorazepate both increase sedation. Use Caution/Monitor.clotrimazoleMinor (1)pentobarbital decreases levels of clotrimazole by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.clozapineMonitor Closely (3)pentobarbital will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. pentobarbital will decrease the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. pentobarbital and clozapine both increase sedation. Use Caution/Monitor.cobimetinibContraindicated (1)pentobarbital will decrease the level or effect of cobimetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Avoid coadministration. Strong or moderate CYP3A inducers may decrease cobimetinib systemic exposure by >80% and reduce its efficacy.cocaine topicalMinor (1)pentobarbital will decrease the level or effect of cocaine topical by affecting hepatic enzyme CYP2B6 metabolism. Minor/Significance Unknown.codeineMonitor Closely (1)pentobarbital and codeine both increase sedation. Use Caution/Monitor.colchicineMonitor Closely (1)pentobarbital will decrease the level or effect of colchicine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.conivaptanMonitor Closely (1)pentobarbital will decrease the level or effect of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.conjugated estrogensMonitor Closely (1)pentobarbital will decrease the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.conjugated estrogens, vaginalMonitor Closely (1)pentobarbital will decrease the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.copanlisibSerious - Use Alternative (1)pentobarbital will decrease the level or effect of copanlisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of copanlisib with strong CYP3A4 inducers.cortisoneMonitor Closely (1)pentobarbital will decrease the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyclizineMonitor Closely (1)cyclizine and pentobarbital both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (1)pentobarbital and cyclobenzaprine both increase sedation. Use Caution/Monitor.cyclophosphamideMonitor Closely (1)pentobarbital will decrease the level or effect of cyclophosphamide by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor.cyclosporineMonitor Closely (1)pentobarbital will decrease the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyproheptadineMonitor Closely (1)cyproheptadine and pentobarbital both increase sedation. Use Caution/Monitor.dabrafenibSerious - Use Alternative (1)pentobarbital decreases levels of dabrafenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.dalteparinSerious - Use Alternative (1)pentobarbital decreases effects of dalteparin by increasing metabolism. Avoid or Use Alternate Drug.dantroleneMonitor Closely (1)pentobarbital and dantrolene both increase sedation. Use Caution/Monitor.dapsoneMinor (1)pentobarbital will decrease the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.daridorexantMonitor Closely (1)pentobarbital and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. Serious - Use Alternative (1)pentobarbital will decrease the level or effect of daridorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.darifenacinMonitor Closely (1)pentobarbital will decrease the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.darunavirMonitor Closely (1)pentobarbital will decrease the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dasatinibMonitor Closely (1)pentobarbital will decrease the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.deflazacortSerious - Use Alternative (1)pentobarbital will decrease the level or effect of deflazacort by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of deflazacort with moderate or strong CYP3A4 inducers.desipramineMonitor Closely (1)pentobarbital and desipramine both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital, desipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.deutetrabenazineMonitor Closely (1)pentobarbital and deutetrabenazine both increase sedation. Use Caution/Monitor.dexamethasoneMonitor Closely (1)pentobarbital will decrease the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and pentobarbital both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)pentobarbital increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)pentobarbital and dexmedetomidine both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)pentobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)pentobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromoramideMonitor Closely (1)pentobarbital and dextromoramide both increase sedation. Use Caution/Monitor.diamorphineMonitor Closely (1)pentobarbital and diamorphine both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (2)pentobarbital will decrease the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. pentobarbital and diazepam both increase sedation. Use Caution/Monitor.diazepam intranasalMonitor Closely (2)pentobarbital will decrease the level or effect of diazepam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Strong or moderate CYP3A4 inducers may increase rate of diazepam elimination; therefore, efficacy of diazepam may be decreased. diazepam intranasal, pentobarbital. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.diclofenacMinor (1)pentobarbital will decrease the level or effect of diclofenac by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.dienogest/estradiol valerateContraindicated (1)pentobarbital will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Women should not choose estradiol valerate/dienogest as their contraceptive while using strong CYP3A4 inducers due to potential decrease in contraceptive efficacy. Estradiol valerate/dienogest should not be used for at least 28 days after discontinuation of the inducer due to possibility of decreased contraceptive efficacy. diethylpropionMonitor Closely (1)pentobarbital increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalinMonitor Closely (1)difelikefalin and pentobarbital both increase sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)pentobarbital and difenoxin hcl both increase sedation. Use Caution/Monitor.dihydroergotamineSerious - Use Alternative (1)pentobarbital will decrease the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.dihydroergotamine intranasalSerious - Use Alternative (1)pentobarbital will decrease the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.diltiazemMonitor Closely (1)pentobarbital will decrease the level or effect of diltiazem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.dimenhydrinateMonitor Closely (1)dimenhydrinate and pentobarbital both increase sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine and pentobarbital both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)pentobarbital and diphenoxylate hcl both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)pentobarbital and dipipanone both increase sedation. Use Caution/Monitor.disopyramideMinor (1)pentobarbital will decrease the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dobutamineMonitor Closely (1)pentobarbital increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.docetaxelMinor (1)pentobarbital will decrease the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.donepezilMinor (1)pentobarbital will decrease the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.dopamineMonitor Closely (1)pentobarbital increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopexamineMonitor Closely (1)pentobarbital increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doravirineContraindicated (1)pentobarbital will decrease the level or effect of doravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of doravirine with a strong CYP3A inducer may decrease doravirine plasma concentrations and/or effects. Potential for loss of virologic response and possible resistance to doravirine. dosulepinMonitor Closely (1)pentobarbital and dosulepin both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital, dosulepin. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.doxepinMonitor Closely (1)pentobarbital and doxepin both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital, doxepin. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.doxorubicinMonitor Closely (1)pentobarbital will decrease the level or effect of doxorubicin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.doxorubicin liposomalMonitor Closely (1)pentobarbital will decrease the level or effect of doxorubicin liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.doxycyclineMonitor Closely (1)pentobarbital decreases levels of doxycycline by increasing metabolism. Use Caution/Monitor.doxylamineMonitor Closely (1)pentobarbital and doxylamine both increase sedation. Use Caution/Monitor.dronabinolMonitor Closely (1)pentobarbital will decrease the level or effect of dronabinol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dronabinol is a CYP3A4 substrate.dronedaroneSerious - Use Alternative (1)pentobarbital will decrease the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.droperidolMonitor Closely (1)pentobarbital and droperidol both increase sedation. Use Caution/Monitor.duloxetineSerious - Use Alternative (1)pentobarbital will decrease the level or effect of duloxetine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.dutasterideMinor (1)pentobarbital will decrease the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.duvelisibSerious - Use Alternative (1)pentobarbital will decrease the level or effect of duvelisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration with a strong CYP3A inducer decreases duvelisib area under the curve (AUC), which may reduce duvelisib efficacy.efavirenzMinor (1)pentobarbital will decrease the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.elacestrantSerious - Use Alternative (1)pentobarbital will decrease the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.elagolixMonitor Closely (1)pentobarbital will decrease the level or effect of elagolix by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.elbasvir/grazoprevirContraindicated (1)pentobarbital will decrease the level or effect of elbasvir/grazoprevir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. The therapeutic effect of elbasvir/grazoprevir may be reduced if coadministered with strong CYP3A inducers and is therefore contraindicated.eletriptanMonitor Closely (1)pentobarbital will decrease the level or effect of eletriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.eliglustatSerious - Use Alternative (1)pentobarbital will decrease the level or effect of eliglustat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong CYP3A inducers significantly decreases eliglustat exposure; coadministration not recommendedeltrombopagMonitor Closely (2)pentobarbital will decrease the level or effect of eltrombopag by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. pentobarbital will decrease the level or effect of eltrombopag by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.elvitegravirSerious - Use Alternative (1)pentobarbital will decrease the level or effect of elvitegravir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid; coadministration with CYP3A inducers may result in decreased plasma concentrations of elvitegravir and/or a concomitantly administered protease inhibitor and lead to loss of therapeutic effect and to possible resistanceelvitegravir/cobicistat/emtricitabine/tenofovir DFContraindicated (1)pentobarbital decreases levels of elvitegravir/cobicistat/emtricitabine/tenofovir DF by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May lead to loss of virologic response and possible resistance.enoxaparinSerious - Use Alternative (1)pentobarbital decreases effects of enoxaparin