What to do if you miss a pill

Missing a pill can be a worry, especially if you’ve recently had unprotected sex. But, missing a pill doesn’t necessarily mean you’ll get pregnant. How protected you are and any extra precautions you might need to take, depends on the type of pill you are taking and the number of pills you have missed.

Knowing what to do when you miss your contraceptive pill will mean you can quickly resolve the situation.

Don’t forget, no contraceptive pill protects against STIs. So make sure you’re getting regularly checked and using condoms to stay protected.  

Provided you know what to do if you miss a contraceptive pill then you should be able to control the situation and quickly return to your normal routine.

What type of pill are you taking?

What you should do if you miss a pill depends on whether you are on the combined contraceptive pill (for example Microgynon or Eloine) or the progestogen-only pill (mini pill). Read our clinicians advice on different types of contraceptive pill.

The main differences between these pills are:

• The combined pill has oestrogen, but the mini pill doesn’t.
• The mini pill is taken every day without a break, but depending on the type, the combined pill can used in different ways.
• With the combined pill you’ll need yearly checks of the your blood pressure, height and weight, but you don’t for the mini pill.

If you are unsure what type of pill you’re on, you can check the packet and search the brand name online.

We’re going to give you some advice on what to do if you miss a pill. But it’s important to check your pill pack for specific instructions, or you can speak to your GP or a pharmacist.  

Combined pill

The combined pill is typically taken daily for 21 days then stopped for 4 or 7 days, during which time you will experience a withdrawal bleed. But there are other ways you can take the combined pill, find out more. 

Everyday pills, for example Microgynon 30 ED, contain 7 inactive (dummy) pills which simply help you know when to start a new pack. You can also take these pills in similar ways to the combined pill. 

You should take combined pills in the correct order and at the same time each day.

Missing the combined pill

If it's been less than 48 hours since your last pill:

• Take your next pill now
• Continue taking the rest of the pack as usual
• You might need to take 2 pill on one day

If it's been between 48 and 72 hours since your last pill:

• Take the last pill you missed now.
• Continue taking the rest of the pack as usual.
• If you're in the first week after a pill-free break, you won't need emergency contraception unless:
  • You started the pack more than 24 hours late
  • You already missed a pill this week
  • Or your missed a pill in the 7 days before your pill-free break.
• If you're in any other week, emergency contraception isn't usually needed, unless you've missed another pill in the last 7 days. 

If it's been more than 72 hours since your last pill:

• Take the last pill you missed now, leave any earlier missed pills. 
• Continue taking the rest of the pack as normal.
• Use extra contraception if you have sex during the next 7 days.
• If you're in the first week after a pill-free break and you've had unprotected sex this week or in the break, you might need emergency contraception. Speak to a clinician.
• If you're in any other week, you shouldn't need emergency contraception, unless you've missed another pill in the last 7 days. 
• If you're due to start a pill-free break within the next 7 days, don't take the break. 

If you started a pack more than 24 hours late after a 7-day pill-free break or 96 hours late after a 4-day pill-free break:

• Start the next pack as soon as you remember.
• Continue the pack as usual.
• Use additional contraception for the next 7 days
• You might need emergency contraception if you’ve had unprotected sex during the pill-free break. Speak to a clinician. 

Progestogen-only pill

The progestogen-only pill (POP) is taken every day without a break. The time window for missing mini pills is much narrower than for combined pills.

Most mini pills should be taken within 3 hours of the same time each day. Certain pills, such as Cerazette, Cerelle and the generic Desogestrel contain the active ingredient desogestrel, can be taken within a 12-hour window of the same time. 

Missing a POP

If you're less than 3 or 12 hours late taking your pill (depending on you pill):

• Take a pill as soon as you remember.
• Take your next pill at the normal time.
• You're protected from pregnancy.

If you're more than 3 or 12 hours late taking your pill (depending on you pill):

• Take a pill as soon as you remember, if you've missed more than one, only take one.
• Take your next pill at the normal time, this might mean taking 2 pills in one day.
• Use another form of contraception if you have sex for the next 2 days.
• You might need emergency contraception if you've had sex in this time, speak to a clinician. 

Remembering your pill

Taking your pill at the correct time is very important. But we all know it’s how easy it is to forget a pill. Here are some tips to help you remember your pill:

• Make your pill part of your daily routine. Take it after brushing your teeth or just before bed.
• Set an alarm on your phone.
• Leave a note to take the pill, someone you’ll always see it, e.g. the fridge door or kettle.
• Know what to do if you miss and pill.

You can always log into your Patient Record to ask us for advice.

Unsure which one is right for you? See our guide on choosing the right contraceptive pill for you.

References

https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
https://www.nhs.uk/conditions/contraception/the-pill-progestogen-only/