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Contraindicated (1)pentobarbital will decrease the level or effect of cariprazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. CYP3A4 is to blame for the formation and elimination of cariprazine's Lively metabolites.pentobarbital decreases levels of panobinostat by impacting hepatic/intestinal enzyme CYP3A4 metabolism.