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pentobarbital will reduce the extent or outcome of midostaurin by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Prevent or Use Alternate Drug. Potent CYP3A4 inducers might lower midostaurin concentrations leading to decreased efficacy.pentobarbital will lower the level or effect of carvedilol by impacting hepatic enzyme CYP2C9/10 metabolis