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pentobarbital will lessen the extent or impact of midostaurin by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Solid CYP3A4 inducers could decrease midostaurin concentrations resulting in reduced efficacy.pentobarbital will lessen the extent or result of bortezomib by affecting hepatic/intestinal enzyme CYP3A4