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pentobarbital will decrease the extent or result of pitolisant by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Intently. Pitolisant exposure is lessened by fifty% if coadministered with strong CYP3A4 inducers.pentobarbital decreases levels of toremifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use