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Why Omeprazole Isn’t Stopping Your Heartburn Anymore

February 17, 2026

Omeprazole might have worked like a magic charm at first, calming your acid reflux or heartburn fast. But what if it suddenly…stops working?

“It doesn’t mean you’re out of luck, or out of options,” says Jeffrey Kwan, MD, a gastroenterologist with PACT Gastroenterology Center and Hartford HealthCare’s Digestive Health program. “It just means we may need to take a closer look at what’s going on and adjust the plan.”

Here’s what to know if your go-to reflux medication isn’t cutting it anymore.

Omeprazole affects your stomach acid production

Omeprazole is a type of proton pump inhibitor (PPI). It’s commonly known by the brand name Prilosec (or Prilosec OTC).

“It reduces the amount of acid your stomach produces,” explains Dr. Kwan. “We use it to treat GERD (gastroesophageal reflux disease), ulcers and other acid-related conditions.”

> Related: Is Acid Reflux Causing My Cough?

But sometimes, it stops working

You’re taking omeprazole as prescribed – so why are you still dealing with heartburn, regurgitation or even a chronic cough?

“It really depends on the person,” says Dr. Kwan. “We’ll look at your symptoms, timing and overall health to figure out what’s going on and how to help.”

Some common reasons omeprazole may not be working:

• Your underlying condition has changed.
• The dose or timing needs to be adjusted.
• You’re dealing with non-acid reflux, which doesn’t respond to PPIs.
• You might have another condition – like dyspepsia, functional heartburn, esophageal motility issues or medication side effects – that mimics reflux.

“Reflux isn’t always just about acid,” adds Dr. Kwan. “That’s a key piece when treatment doesn’t seem to be helping.”

> Related: 7 Things That Might Be Making Your Acid Reflux Worse

What to do when omeprazole stops working

If omeprazole is not working anymore – don’t wait it out – and don’t stop it suddenly.

“We can look into a few different strategies, depending on your symptoms and history,” says Dr. Kwan.

Your doctor may recommend:

• Adjusting the dose, or when or how you take the medication. “PPIs like omeprazole work best when taken 30 to 60 minutes before your first meal of the day,” says Dr. Kwan. “Taking it inconsistently or at random times – or after eating – can make it less effective.”
• Trying a different PPI or adding a second type of medication.
• Evaluating for non-acid reflux, medication-related irritation or other GI conditions.
• Ordering tests, like endoscopy or pH monitoring, for a closer look.
• Discussing procedural or surgical options if symptoms are severe or long-standing.

Don’t forget about your diet – and daily habits

Medications or not, lifestyle factors play a big role in controlling reflux.

Dr. Kwan offers some tips.

Foods to limit:

• Spicy, fried or fatty foods.
• Tomato sauces, citrus fruits, chocolate and peppermint.
• Coffee and alcohol.
• Large meals or late-night snacks.

Foods to eat more of:

• High-fiber choices like oats, sweet potatoes and green veggies.
• Alkaline foods such as bananas and cauliflower.
• Watery foods like cucumbers, lettuce and broth-based soups.

Daily habits that help:

• Eat smaller meals and don’t lie down right after.
• Maintain a healthy weight.
• Avoid smoking.
• Raise your bed head 6–8 inches to ease nighttime reflux.
• Skip tight clothes or belts that press on your stomach.

“Sometimes it’s not just about the stomach – stress, weight changes and other lifestyle shifts can all play a role,” says Dr. Kwan.

> Related: Got Heartburn? What to Eat (and Avoid) for Acid Reflux

Talk to your doctor today

If you’re thinking about stopping omeprazole, it’s best to check with your doctor first.

“We don’t want patients tapering or switching medications on their own,” says Dr. Kwan. “We can walk you through the options, monitor for side effects and make sure you’re getting the relief you need, safely.”

If you’re still struggling and omeprazole is not working the way it once did, don’t give up or go it alone. A conversation with your doctor can help uncover what’s really driving your symptoms and what might help next.