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phenytoin will lessen the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Closely. Coadministration of fentanyl with CYP3A4 inducers may lead to your reduce in fentanyl plasma concentrations, lack of efficacy or, potentially, growth of a withdrawal syndrome inside of a patient who'