Most common side effect is nausea (I never had it), that's why it sometimes says "take with food" on the box. "Food" in this context does not mean a meal, just a biscuit will do. Drink a glassful of water with it to send it on its way. Ideally take it on an empty stomach. Levodopa (the main ingredient) is an amino acid and competes with others in the absorption process. Too much food, and especiallt protein would delay absorption or even not be taken up at all. Some people are more sensitive to this than others. Generally there are fewer side effects of Sinemet (or other levodopa products) than with the dopamine agonists, like Requip . Sinemet also will be better at dealing with the Parkinson symptoms too.I take my first dose when I get up in the morning. Divide the other two portions equally over the day, for instance at --- 8------14-----20-- or ---8---13 ---18.- Take half an hour before meals and/or at least 1,5 hours after meals ..In the beginiing it is a bit of experimenting with the timings to see what suits you best.