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pentobarbital will minimize the extent or effect of tramadol by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Reduced AUC of tramadol plus the active metabolite (O-desmethyltramadol) when coadministered with solid CYP3A4 and CYP2B6 inducersThere is a extremely basic principle in medicine, primum non nocere, a Latin a