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pentobarbital will reduce the level or impact of midostaurin by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potent CYP3A4 inducers may possibly minimize midostaurin concentrations leading to diminished efficacy.pentobarbital will lessen the level or impact of eltrombopag by affecting hepatic enzyme CYP2C9/ten