I have taken it both ways (overseas travel plays havoc with my pill box!) and it hasn't made any difference, but then again I haven't been having these side effects anyway. As far as I know there is no issue about before or after food, although my package (chemist label) warns it can affect alertness and to "beware of driving". I don't drive, I have never felt any drowsiness and I have no great confidence in labels slapped on by chemists! The manufacturer lists the usual long list of possible side effects, but doesn't emphasise bone density impact and vaginal dryness, neither of which are uncommon. Also says it is not food affected. Ah the joys of drugs!