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pentobarbital will lower the extent or impact of siponimod by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a drug that triggers average CYP2C9 plus a moderate or powerful CYP3A4 inducer is not advisable.buprenorphine transdermal and pentobarbital equally improve sedation. Ste