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pentobarbital will reduce the level or impact of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Keep track of.pentobarbital will reduce the level or effect of brexpiprazole by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Closely. Double brexpiprazole dose more than 1-two week