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phenobarbital raises toxicity of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Monitor. CYP3A4 inducers could improve the metabolism of ifosfamide to its Energetic alkylating metabolites.Monitor Carefully (one)somatropin will reduce the level or impact of phenobarbital by influencing hepatic/intestinal enzyme CYP3