CYP3A4 inducers may raise the formation from the neurotoxic/nephrotoxic ifosfamide metabolite, chloroacetaldehyde. Closely keep track of clients using ifosfamide with CYP3A4 inducers for toxicities and consider dose adjustment.pentobarbital will lower the extent or result of pitolisant by influencing hepatic/intestinal enzyme CYP3A4 metabolism. Mod