pentobarbital will reduce the level or effect of midostaurin by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Robust CYP3A4 inducers may well decrease midostaurin concentrations resulting in lessened efficacy.pentobarbital will lessen the level or result of ibuprofen by impacting hepatic enzyme CYP2C9/10 meta