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pentobarbital will lower the level or impact of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Steer clear of or Use Alternate Drug. Robust CYP3A4 inducers might lower midostaurin concentrations resulting in decreased efficacy.pentobarbital will reduce the extent or impact of ibuprofen by impacting hepatic enzyme CYP2C9/ten m