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Missed pills

It is well known that birth control pills should be taken regularly every day (preferably before going to sleep), at the same time and pills should not be missed. But what if you accidentally missed your contraceptive pill? Could missed pills mean cancellation of contraception? What you should do and which kind of side effects you should expect?

Everything depends on which kind of contraceptive pills you are using, how many pills you missed and when exactly you missed the pill.

Missed pills – Combined contraceptive pills

Combined contraceptive pills have high rates of effectiveness if they are used consistently according to specific instructions for each type of birth control pills.

If you missed one active (hormone) pill, just take it immediately as soon as you remember and continue as it was schedules or just take a double dose the next day. If you did not pass yet the ovulation period, the backup birth control method is recommended during following seven days.

If you missed more than one active contraceptive pill, the compensation will be different. Important to know that in these cases it is necessary to use the backup method for next seven days.

If you missed two pills, double up on pills the next day and the following one – it means 2 birth control pills on the day you missed and another 2 pills on next day. After that – just continue as scheduled.

If you missed three or more pills, it means your hormone levels are disrupted and contraceptive effect is going down. Better to throw out your old pack and start a new one. If you had unprotected sex during this period, emergency contraception could be the only solution.

If you missed inactive pill, just ignore and continue taking active pills as it was scheduled. No backup methods would be needed for next seven days.

If you had unprotected sex during the time that you missed active pills (without using backup method of contraception), you can use emergency contraception for pregnancy prevention. Emergency contraception should be used during 72 hour after unprotected intercourse but sooner is better.

Missed pills during some diseases

It could happen that you did not forget to take your contraceptive pill but some illnesses could act as “missed pill”. For example, during flu, vomiting and/or diarrhea you can miss your pill or the effectiveness of your daily pill could be decreased dramatically. In these cases it is strongly recommended to use the backup method of contraception during following seven days or avoid sexual contacts during same seven days.

It is important to know that some drugs also can develop the effect of “missed pills”. If you take some drugs prescribed for your illnesses and use contraceptive pills at the same time, you may not have the expected protection from unplanned pregnancy you think you do.

Missed pills

Missed pills

If you are using birth control pills or any other hormonal contraception, you need to know the list of drugs which can reduce the activity of your contraception:

  • Antibiotics (check also “Birth control pills and antibiotics”);
  • Anti-HIV Drugs – Darunavir (Prezista), Efavirenz (Sustiva), Lopinavir (Ritonavir, Kaletra), Nevirapine (Viramune);
  • Anti-fungal drugs (check also “Birth control pills and yeast infection”);
  • Anti-seizure medication – Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), Felbamate (Felbatol), Oxcarbazepine (Trileptal), Phenobarbital (Luminal), Phenytoin (Dilantin, Phenytek), Primidone (Mysoline), Topiramate (Topamax);
  • Anti sleep disorders – Modafinil (Provigil).

Missed pills – Mini pills (Progestin-only pills)

Mini pills are more sensitive to timing than combined pills and they should be also taken every day at the same time (preferably before going to sleep).

Traditional progestin-only pills (Micronor, Norgeston, Noriday)

If the pill is taken 3 hours or more after the chosen time, take it immediately as soon as you remember and continue taking pills as scheduled – it could mean taking 2 pills at the same time on the day you remember. Don’t take more than 2 pills on the same day.

Backup contraception or abstain is recommended during 48 hours after the missed pill is taken. It takes two days for the progestogen-only pill to thicken cervical mucus so that sperm cannot get through or survive. If you had unprotected sex before the 48 hour period has passed, better to use the emergency contraception.

Progestin-only pills with desogestrel (Cerazette or Cerelle)

If the pill is taken 12 hours or more after the chosen time, take it immediately as soon as you remember and continue taking pills as scheduled. More than 2 pills per day are not recommended.

Backup methods for pregnancy prevention or abstain are recommended during following 48 hours after the missed pill is taken. In cases of unprotected sex before the 48 hour period has passed, the Plan B is recommended.

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