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pentobarbital will lower the extent or impact of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Slight/Significance Mysterious.pentobarbital decreases levels of toremifene by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Watch. CYP3A4 inducers improve charge of toremifene metabolism, lowering the continu