May mask a progressive ileus &/or gastric distention. Serotonin syndrome is associated w/ the use of the patch, particularly w/ concomitant use of serotonergic drugs. Remove patch if severe reactions or a generalized skin reaction occur. Avoid exposing the patch & surrounding area to direct external heat sources eg, heating pads. Avoid direct exposure of application site to natural or artificial sunlight. Pregnancy & lactation. Childn. Elderly.