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pentobarbital will lower the level or result of sildenafil by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potent CYP3A4 inducers are envisioned to bring about substantial decreases in sildenafil plasma amountspentobarbital will lower the extent or effect of estrogens esterified by influencing hepatic/intest