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pentobarbital will lower the level or effect of tramadol by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Keep an eye on. Decreased AUC of tramadol along with the active metabolite (O-desmethyltramadol) when coadministered with potent CYP3A4 and CYP2B6 inducersAged clients might respond to barbiturates with marked enjoyment, de