pentobarbital will reduce the level or outcome of netupitant/palonosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stay away from or Use Alternate Drug. Netupitant is principally metabolized by CYP3A4; steer clear of use in sufferers who're chronically using a powerful CYP3A4 inducerUse with warning in pregnant women and kids below