Everything I've read, including what the pharmacist told me was to take it with food. This is because it can cause upset stomach and gastritis. That said I normally took my medications including prednisone before eating and never had an issue with an upset stomach. It would be a good question to ask your doctor or rheumatologist. I think it depends on the individual and the warning is to prevent an issue from taking the prednisone. I normally get up at 5 am and have a routine of things to do after which I take my medications. Then it's sometimes an hour or longer before I eat anything. I'm sure others have similar and different routines when taking meds.