Missed a pill? Don’t panic

Forgot your pill? Deep breath. What you need to do depends on your pill type, how late you are, and where you are in your pack. Your pill leaflet is always the final word – and pharmacists are brilliant at this. Here’s the general UK guidance from NHS sexual health services.

A combined pill counts as missed once it is more than 24 hours late. So one pill missed means it has been 48 to 72 hours since you took your last pill, and two or more missed means it has been more than 72 hours.

Combined pill

• One pill missed (any week, any pack): take the missed pill now, even if that means two in one day, and carry on as normal. You don’t need extra protection or emergency contraception.
• Two or more pills missed: take the most recent missed pill now (leave the earlier ones), carry on as normal, and use condoms or avoid sex until you’ve taken 7 pills in a row.
• Two or more missed in week 1 (the 7 days after your break) and you had sex in the break or in week 1: you may need emergency contraception, so ask a pharmacist as soon as you can.
• Two or more missed in week 2: if you took the 7 pills before them correctly, you don’t need emergency contraception.
• Two or more missed in week 3: finish the active pills in this pack, then start the next pack straight away with no break (and skip any dummy pills).

Mini pill (POP)

• Traditional (more than 3 hours late) or desogestrel (more than 12 hours late): take the missed pill now, take the next one at your usual time (even if that means two in a day), and use condoms or avoid sex for the next 2 days (48 hours).
• Drospirenone (more than 24 hours late): take the missed pill now, carry on, and use condoms or avoid sex for the next 7 days. If any of the last 7 active pills in a pack were missed, skip the dummy pills and start the next pack straight away.
• If you had sex after the pill was late and before protection was back, ask a pharmacist about emergency contraception. Sex before the missed pill is not a worry for traditional and desogestrel pills.

Sick or diarrhoea?

If you vomit within 3 hours of a combined pill, take another as soon as you can keep it down. Severe diarrhoea (more than 24 hours) can stop the pill being absorbed, so follow the missed pill advice above. For the mini pill, being sick within 2 to 4 hours of a pill (depending on the type) means it may not have been absorbed, so treat it as a missed pill. The patch and ring aren’t affected by sickness.