pentobarbital will reduce the extent or impact of netupitant/palonosetron by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Stay away from or Use Alternate Drug. Netupitant is principally metabolized by CYP3A4; steer clear of use in clients who're chronically working with a strong CYP3A4 inducerBut although the bill experienced handed in