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CYP3A4 inducers may raise the development in the neurotoxic/nephrotoxic ifosfamide metabolite, chloroacetaldehyde. Intently keep track of clients taking ifosfamide with CYP3A4 inducers for toxicities and consider dose adjustment.pentobarbital will lower the level or effect of linagliptin by influencing hepatic/intestinal enzyme CYP3A4 metabolism. U