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Contraindicated (one)pentobarbital decreases amounts of vandetanib by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Keep away from coadministration with powerful CYP3A4 inducers; these medications lessen publicity to vandetanib by as many as 40%.pentobarbital will lessen the extent or outcome of ramelteon by impacting hepa