pentobarbital will lower the extent or outcome of midostaurin by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Stay away from or Use Alternate Drug. Potent CYP3A4 inducers might reduce midostaurin concentrations leading to diminished efficacy.pentobarbital will lessen the extent or result of ibuprofen by impacting hepatic enzyme CYP2C9/1