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pentobarbital will decrease the extent or impact of netupitant/palonosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stay clear of or Use Alternate Drug. Netupitant is principally metabolized by CYP3A4; stay away from use in patients who're chronically making use of a solid CYP3A4 inducerReally should signs of withdrawal take place