Several people were asking about taking pills with or after food. I looked at my pack of metformin as I was taking them this morning. The instructions on the label said WITH or AFTER food. I needed to take a pill this morning but didn't have time for a proper breakfast. I got to work and my tummy was doing it's best to misbehave. So if it says WITH or AFTER food and you don't, the side effects will come back and haunt you for several hours...