pentobarbital will lessen the extent or influence of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Prevent or Use Alternate Drug. Netupitant is especially metabolized by CYP3A4; keep away from use in sufferers who're chronically applying a solid CYP3A4 inducerEpileptic syndromes that trigger myoclonic seizures ge