It doesn't matter who goes first, Zombie. The game's already decided which is going to win, and the cakes, kunais and whatnot that get tossed around are just to build the suspense.
Don't let the One Pill axiom cloud common sense, boys and girls. If your
Brandon is going up against an enemy
Aldo and both clan bonuses are in effect, you're already at double his base of 4. 4+8(
Junkz bonus)-12, min. 8 (Montanas bonus). Add one pill, or even two, and you're not actually changing your attack at all.
On the other hand, just because your opponent is at two health and your
Mario (again, with Clan bonus) has 1.5 times the power of your pilless opponent's
Tank doesn't mean you should save your last pill to improve your score. I don't care what the official odds on her winning are, it's a total coin flip on if your saving that pill will cost you the KO-and with her 5 damage, it might cost you your win completely. Especially when it's anybody's game on that last round, try to ensure a Sure Shot.