Pentobarbital will lower the extent or effect of ramelteon by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Importance Unfamiliar. Barbiturates can induce hepatic microsomal enzymes leading to enhanced metabolism and lowered anticoagulant response of oral anticoagulants (eg, warfarin, acenocoumarol, dicumarol, and phenprocoumon); patients stabilized on anticoagulant t... https://is-nembutal-legal-in-cana27147.ampedpages.com/is-nembutal-a-barbiturate-fundamentals-explained-58195896