 [ Symptoms ] my new omeprazole prescription 40 mg twice daily is working but must i always take it on an empty stomach [ Disease ] omeprazole 40 mg twice daily is a high dose and is not recommended over a long period of time it is a safe and effective medication used within the recommended prescribing guidelines the medication is intended to decrease the release of stomach acid therefore it is the most effective if taken 30 minutes prior to having a meal this medication has 24 hour coverage therefore it should not be taken prior to every meal it is intended to be taken on an empty stomach if you take it with food the stomach will release acid to digest the food the acid can decrease the absorption of the medication and decrease the effectiveness therefore i would not recommend taking the medication with food or a meal it is important to take the dose 30 minutes prior to a meal or first thing in the morning