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phenobarbital will lower the level or influence of ramelteon by impacting hepatic enzyme CYP2C9/10 metabolism. Small/Importance Mysterious.phenobarbital decreases levels of vandetanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Stay away from coadministration with potent CYP3A4 inducers; these drugs cut down exposure