pentobarbital will minimize the level or effect of ramelteon by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Small/Importance Unfamiliar.pentobarbital will minimize the extent or effect of brexpiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Observe Carefully. Double brexpiprazole dose more than 1-2 weeks