Ashley always takes his med’s without a drink or food.  He has never had any problems as yet, unless he is on really high doses, i.e. x5 times more than normal dose = 100mg per day in x4 doses of 25mg has really irritated his gut and we had to use antacids for a few days.  He had also been vomiting, so it is hard to tell if it is one or the other with him but I suspect it is the cortisol when the doses are so high--in his case anyway.