pentobarbital will minimize the level or influence of netupitant/palonosetron by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Netupitant is mainly metabolized by CYP3A4; steer clear of use in patients who're chronically applying a robust CYP3A4 inducerAccording to AAN tips on convulsive standing epilepticus, E