pentobarbital will minimize the extent or impact of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Keep away from or Use Alternate Drug. Netupitant is especially metabolized by CYP3A4; stay clear of use in patients who are chronically utilizing a powerful CYP3A4 inducerPentobarbital belongs to a class of remedies