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cenobamate will lower the level or influence of fentanyl transdermal by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as necessary, when coadministered with cenobamate.eluxadoline boosts amounts of fentanyl transdermal by impacting hepatic/intestinal enzyme CYP3A4 metabol