Aside from the usual inquiries regarding the reliability and the safety of contraceptive pills, one of the most commonly posed questions on the topic is – what to do if I forget to take my pill.

What’s on this page?

It happens. You might be somewhere outside and left your pills at home, or it might have just slipped your mind. Practically every woman who has been taking hormonal oral contraceptives has forgotten to take a pill at some point. But this brings up a lot of rather uncomfortable questions:

  • How will missing a pill impact the efficiency of the pill?
  • Are you at risk?
  • How to continue with the treatment?
  • What to do next?

The answer to the last question, and to an extent to all the other will largely depend on the exact brand and type of the contraceptive pills you are taking. Another important factor is the number of missed pills.

While these specific scenarios will be discussed in time, there are some general answers that will, hopefully, help you get a better idea of how to proceed and even more importantly, that will help you calm down.

  • First of all, don’t panic – this happens and it’s not the end of the world
  • The patient information leaflet will contain information on this and will provide you further guidance
  • Your doctor or pharmacist will be able to provide you with specific advice on how to proceed

But, let’s take a deeper look at the question while taking into account the specific issues that might arise due to the nature of the pill you are taking.

Missing combined contraceptive pill

If you are using combined contraceptives, pills that contain synthetic versions of both progesterone and oestrogen, we have some good news for you! Combined oral contraceptives offer you a rather large window of opportunity to make up for the missed pill. In fact, starting the treatment one day late or missing just one pill is highly unlikely to affect the protection provided by the pill, making it unnecessary to use additional barrier contraceptives.

But, there are still certain things that you should keep in mind. Ideally, you should:

  • Take the pill when you do remember, even if it means taking two pills on the same day
  • Do not make adjustments to the no-pill (or inactive pills) period at the end of the monthly cycle
  • Continue with the treatment like before the missed pill, without introducing any changes into your routine

However, if you missed two or more pills or are late with your treatment two or more days, the situation isn’t quite the same. You should still take the latest missed pill as soon as you remember, while disregarding the other missed pills. After that, you should continue with the treatment as usual, but barrier contraception should be used as a precaution for the next seven days, starting from the day when you remembered to take the missed pill.

In addition to this, there are different options depending on how far are you in your monthly course. If you have more than seven pills remaining after you take the missed ones, then you should certainly continue as usual. Otherwise, if less than seven pills are remaining, you should skip the no-pills or inactive pills period and continue with the treatment (new pack of the birth control tablets you have been using) as soon as you finish with the previous one.

When should I use emergency contraception?

If you miss a combined birth control pill, emergency contraception shouldn’t be used in most cases. The opposite is true if you had unprotected sex in the first seven days following the missed pill or if you have missed more than one pill during the first seven days of the monthly cycle. Of course, the timespan when you can use emergency contraceptives will largely depend on exact brand available in your pharmacy.

Missing the mini-pill

When it comes to progesterone-only pills (POPs), also known as mini-pills, the situation is somewhat different. In fact, one of the often mentioned disadvantages of this contraceptive method is a relatively small window of opportunity for recover following a missed pill. In fact, with progesterone-only pills you can afford to be late just 3 hours (12 hours in case of Cerazette) and not worry about it. Any longer delays will require you to undertake certain steps:

  • Take the missed pill as soon as you remember, even if it means taking two pills on the same days
  • Disregard the other missed pills (if any)
  • Use additional barrier contraception for at least two days (or seven in case of Cerazette) following the missed pill

Missing multiphasic birth control pills

If you miss a multiphasic oral contraceptive such as Qlaira, you will be required to consult the official patient information leaflet. There, you will find a flow chart that will help you decide how to proceed for optimal results.

Of course, the above is true if you missed an active pill. In case of inactive pill, simply disregard the missed one to avoid confusion, but it will not compromise the protection offered.