pentobarbital will reduce the extent or influence of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Prevent or Use Alternate Drug. Netupitant is especially metabolized by CYP3A4; steer clear of use in people who are chronically using a powerful CYP3A4 inducerpentobarbital will decrease the level or impact of ambri