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pentobarbital will lower the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Observe.pentobarbital will decrease the level or effect of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Keep away from or Use Alternate Drug. Netupitant is mainly metabolized by CYP3A4