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Istradefylline 40 mg/day elevated peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline twenty mg/day. Consider dose reduction of delicate CYP3A4 substrates.If coadministration of CYP3A4 inhibitors with fentanyl is critical, keep track of patients for respiratory depression and sedation at fre