pentobarbital will lower the level or outcome of netupitant/palonosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Prevent or Use Alternate Drug. Netupitant is especially metabolized by CYP3A4; steer clear of use in sufferers who are chronically using a solid CYP3A4 inducerBarbiturates are medications that trigger you to definitely