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Contraindicated (one)pentobarbital will lower the level or effect of dienogest/estradiol valerate by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Gals must not decide on estradiol valerate/dienogest as their contraceptive while using sturdy CYP3A4 inducers as a result of prospective decrease in contraceptive efficacy.pent