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Istradefylline 40 mg/day greater peak levels and AUC of CYP3A4 substrates in clinical trials. This effect wasn't observed with istradefylline 20 mg/day. Consider dose reduction of delicate CYP3A4 substrates.viloxazine will raise the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Warning/Check. Viloxazine (