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pentobarbital will lower the extent or effect of midostaurin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Prevent or Use Alternate Drug. Potent CYP3A4 inducers might lower midostaurin concentrations causing lessened efficacy.pentobarbital will minimize the extent or effect of ibuprofen by impacting hepatic enzyme CYP2C9/ten metabolism.