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Contraindicated (1)pentobarbital decreases amounts of vandetanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Steer clear of coadministration with strong CYP3A4 inducers; these medications cut down exposure to vandetanib by as much as 40%.pentobarbital will reduce the extent or effect of siponimod by impacting hepatic/