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pentobarbital will decrease the level or outcome of tamoxifen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Watch.pentobarbital decreases levels of elvitegravir/cobicistat/emtricitabine/tenofovir DF by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. May possibly result in lack of virologic response