pentobarbital will reduce the level or effect of ketoconazole by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Small/Significance Not known.pentobarbital will lower the extent or effect of clarithromycin by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Minimal/Importance Unfamiliar.However, Monroe, like Judy Garland, Michael Jac