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pentobarbital will lower the extent or effect of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Keep away from or Use Alternate Drug. Robust CYP3A4 inducers might minimize midostaurin concentrations leading to reduced efficacy.pentobarbital will lower the level or result of carvedilol by impacting hepatic enzyme CYP2C9/10 met