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pentobarbital will reduce the extent or impact of ramelteon by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Slight/Importance Unfamiliar.Barbiturates can induce hepatic microsomal enzymes resulting in amplified metabolism and decreased anticoagulant response of oral anticoagulants (eg, warfarin, acenocoumarol, dicumarol, and phenprocoum