pentobarbital will lessen the level or influence of tofacitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Monitor. Lack of, or lowered reaction to tofacitinib may come about when coadministered with strong CYP3A4 inducerspentobarbital will decrease the level or outcome of midostaurin by influencing hepatic/intestinal enz