Ay, honestly hindi ko sure kung same ang effectiveness kahit walang kain, kaya better ask your OB para ma-clarify talaga! Pero from what a few of us tried, most pills ay mas okay kung may kain kasi hindi gaano upset ang stomach, at mas consistent din ang absorption, pero that's more about comfort than effectiveness talaga, if that makes sense? Your doctor lang talaga ang makakapag-advise ng tama based sa specific brand you're taking, because different pills have different instructions, sis.