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Contraindicated (one)pentobarbital will lower the extent or impact of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Girls mustn't decide on estradiol valerate/dienogest as their contraceptive when making use of sturdy CYP3A4 inducers due to likely lower in contraceptive efficacy.fentanyl tra