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pentobarbital will decrease the level or effect of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Powerful CYP3A4 inducers could lessen midostaurin concentrations leading to decreased efficacy.pentobarbital will minimize the level or result of ibuprofen by impacting hepatic enzyme CYP2C9/10 metabo