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Missed, forgotten or late pills: A guide on what to do

Missed, forgotten or late pills: A guide on what to do

First, don’t worry. It happens to everyone, and it’s simple to get back on track. The rules on what to do if you’ve missed a pill (or taken it late) depend on which type of birth control you’re taking. Most specifically, they depend on whether you’re using combined pills or a progesterone-only mini pill — but some individual brands have their own rules as well. Below, we’ll go over some basic guidelines for what to do if you’ve missed a pill and address the rules for some of the most popular contraception brands.

Missing one or two pills every now and then is no big deal, but if you find yourself missing pills regularly, a daily birth control pill might just not be your thing. That’s ok too. If you’ve tried all the tips like setting an alarm on your phone (we’ve got a list full of tips further down the page), consider switching to a less high-maintenance contraceptive like tthe long-acting reversible contraceptive (LARC) like the injection or IUD

Navkaran Singh Sandhu
Medically reviewed by
Navkaran Singh Sandhu, Clinical Lead
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Medically reviewed by
Dr Navkaran Singh Sandhu
Clinical Lead
on November 18, 2022.
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What’s the difference between a “late” and “missed” pill?

Many types of birth control distinguish between a “late” and “missed” pill in terms of what you should do to get back on track. Depending on the brand, if you took your birth control 4 hours late, you might just need to take it once you’ve remembered — no harm. But with other medication, being just 12 hours late in taking your birth control pill can mean a drop in your protection against pregnancy.

combined pill is considered late if fewer than 24 hours have passed since the time you normally take your pill. It’s considered missed after more than 24 hours. A progesterone-only mini pill, however, is considered missed if it’s more than 12 hours late.

Are there ever times when you’ve missed one birth control pill and don’t need to do anything? Yes, if the pill you missed was one of the placebo pills in your pack. Many types of birth control include a few days or a full week of “spacer” pills which don’t contain any hormones but are meant to be taken to keep you in your daily habit.

What to do about forgotten or missed mini pills

A mini pill is a birth control pill that only contains the hormone progestin. Despite the name, it’s not actually any smaller than a combined birth control pill. Many women prefer mini pills because they get side effects when they take estrogen; for some women, like those over 35, progestogen-only contraception is usually recommended. 

Because mini pills only have one hormone and often contain lower doses compared to combined pills, your window for taking the pill is smaller — sometimes only 3 hours. 

The rules for late or missed mini pills depend on the type of progestin that’s in the medication. If you look at your pack, it’ll list one main ingredient. That’s the progestogen. If you’re taking a mini pill that uses desogestrel as its active ingredient, you’ve got 12 hours before your pill is considered missed, as opposed to 3. 

Here’s what you should do if your pill is late but not yet missed:

  • Take your late pill as soon as you remember
  • Take your next pill at your normal time

While your pill is late, you’re still protected from pregnancy. That means you don’t need to use a back-up birth control like a condom, and you don’t need emergency contraception if you’ve had sex. 

If you’ve missed your mini pill, you’re not protected against pregnancy. Here’s what you should do:

  • Take your missed pill as soon as you remember
  • Take your next pill at your normal time (even if that means taking two in one day)
  • Use back-up contraception like condoms for 48 hours
  • Talk to your doctor about emergency contraception if you have unprotected sex in the 48 hours after your missed pill

Cristina and Unwanted 21 are both combination pills, which means you’ve got 12 hours before your late pill is missed. So if you’ve missed a Crisanta pill or missed an Unwanted 21 pill and less than 12 hours have passed, you’re still protected against pregnancy and don’t need to worry — just take your birth control as soon as you remember.

Most mini pills have a 3-hour window during which they need to be taken. The one exception is pills containing desogestrel, like Cerazette that have a 12-hour window before it is considered a missed pill. Once you’ve passed that twelve-hour marker, you’re not considered protected against pregnancy and should use a back-up method like condoms.

What to do about forgotten or missed combined pills

Because combined pills work a little differently, they have their own rules for what you should do when you miss a pill. Here are some general missed pill guidelines for your combined oral contraceptive pill (COCP). 

If you’ve missed one pill (anywhere in your pack) or started your pack one day late, you’re still protected and don’t need to worry. Here’s what you should do:

  • Take your missed pill as soon as you remember
  • Take your next pill at your normal time

If you’ve missed two or more pills or started your pack 48 hours late (or more), you might not be fully protected against pregnancy. Here’s what you should do:

  • Take your missed pill as soon as you remember
  • Take your next pill at your normal time
  • Use back-up contraception like condoms for 7 days 
  • Talk to your doctor about emergency contraception if your missed pills were from the first week of your pack, or if you have unprotected sex
  • If there are fewer than seven pills left in your pack, skip the inactive pills and start your next pack immediately

What to do about missing more than one pill

Whether you’ve skipped a day of birth control, missed 4 pills of birth control or missed an entire month of birth control, the most important thing is to get back on track and use condoms whenever you have sex. The specific instructions for what to do if you miss a birth control pill depend on the type of pill (combined or mini pill) and sometimes on the brand as well. We’ve covered a few scenarios above, but it’s best to take a look at the patient info that comes with your birth control.

For some types of birth control, when you miss a pill is as important as how many you’ve missed. This can be because your body is doing different things throughout your cycle, which changes how likely you are to get pregnant, or because the pill you’re taking has different levels of hormones throughout the month. If you’ve missed a pill in week 1, for example, you might need to do something different than if you’d missed a pill in week 2. The best thing to do when you miss a pill is to check the patient info that came with it, or to look up instructions for that specific pill.

So are you protected the first week of birth control? Maybe. If you start your birth control on the first day of your period, you’re protected right away. This is called being a Day 1 Starter or a First Day Starter, and you’ll see that term in the instructions for what to do when you miss a pill. If you start the pill at a different time, you should wait 7 days before having unprotected sex.

It’s possible to experience bleeding after missing birth control pills. This usually isn’t anything to worry about and some people can experience spotting or cramping throughout their cycle, even when they haven’t missed a birth control pill.

Bleeding after missing 2 birth control pills isn’t an issue as long as you follow your pill’s directions for getting back on track. This usually involves taking your missing pill and possibly using back-up birth control like condoms until you’re protected against pregnancy again.

Starting a pack late: do I need to do anything differently?

It depends on how late you’ve started the pack. If it’s just one day, that’s no big deal. Just take the pill as soon as you remember, even if that means taking two in one day.

If you’re starting your pack more than one day late, you should wait a week before having unprotected sex. Use a back-up method like condoms in the meantime so you stay protected.

What’s the best way to never miss a pill?

The best way to never miss a pill is to find a time that works for you every day of the week. Here are a few tips.

  • Pick a time that works for every day of the week, not just workdays
  • Set an alarm on your phone, or download a birth control reminder app
  • Store your pills in the same place, like your purse, so they’re always handy
  • Take the pill with other daily medication, like vitamins or prescriptions

Have a meeting happening right when you normally take the pill? Or, are you traveling to a different time zone and not wanting to get up at 3am to take your medication? If you’re wondering “Can I change the time of my birth control pill,” the answer is thankfully yes. But there might be a few challenges.

You can usually take birth control an hour early without any problem. Some pills have a three-hour window during which you need to take them, but many are even more flexible. You should check the specific information provided with your pill to find out what the rules are.

If your pill has a three-hour window but you’re traveling to a different time zone, you can adjust the time day by day — for example, take your pill two hours after you normally do until it matches up with the time where you are. Using a back-up birth control like a condom can help you stay extra-protected while you do this.

Can you take birth control pills with food? Yes. Do you need to? Nope.

It’s uncommon to have stomach upset from taking your pill, but a small snack can help if you do experience this. There’s no other benefit to taking your pill with food, unless having your medication with a meal can help you get into the routine of taking it daily.

If you eat at regular times throughout the week (including working days, weekends, etc), you’re a good candidate for taking your pill with food. But if your meal-times depend on when you get up, when you’re hungry or when you have a break, you might end up taking your birth control inconsistently.

Choosing the best birth control for your life

Ultimately, you’re going to want a birth control that keeps you safe, fits easily into your life and has few if any side effects. But that pill can be hard to find. Talk to an expert and get customized recommendations on the birth control pill that works best with your unique medical history, lifestyle and what you’re looking for in a pill. And be sure to let us know if you have concerns about specific side effects or want a multi-tasking pill that can help with things like acne or your period.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

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