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pentobarbital will lower the extent or impact of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Stay clear of or Use Alternate Drug. Netupitant is principally metabolized by CYP3A4; stay clear of use in people who're chronically using a solid CYP3A4 inducerUse with caution in pregnant Gals and kids under 3 several