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Observe Closely (1)lenacapavir will enhance the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism.butorphanol decreases effects of fentanyl by pharmacodynamic antagonism. Stay away from or Use Alternate Drug. Coadministration of mixed agonist/antagonist and partial agonist opioid analgesics could lower fentanyl's