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CYP2B6 is The key CYP enzyme linked to the metabolism of S-methadone also to an extent, R-methadone. The expression of CYP2B6Opioids (Combined Agonist / Antagonist): May well diminish the analgesic effect of Opioid Agonists. Management: Request alternatives to mixed agonist/antagonist opioids in patients acquiring pure opioid agonists, and monitor