pentobarbital will decrease the extent or effect of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Stay away from or Use Alternate Drug. Netupitant is mainly metabolized by CYP3A4; stay clear of use in sufferers who will be chronically making use of a solid CYP3A4 inducerhealth and fitness facilities / rest center