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pentobarbital decreases amounts of toremifene by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. CYP3A4 inducers enhance level of toremifene metabolism, lowering the regular-condition focus in serum.pentobarbital will lower the extent or impact of tadalafil by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use