Missed a pill: what to do now

Whether a missed tablet matters depends on three things: which preparation, how many hours late and which week of the pack. So the answer is never simply “take it later” – it depends on your situation. This decision aid follows the manufacturers’ instructions and the guidance of the Faculty of Sexual and Reproductive Healthcare.

Before you start

This decision aid follows the guidance of the Faculty of Sexual and Reproductive Healthcare and the manufacturers’ instructions. It cannot replace the package leaflet of your own preparation – and in case of doubt, call the practice or a pharmacy rather than waiting.

1. Which preparation do you take?
Counted from the time you usually take it. One whole forgotten day is 24 hours.
Only relevant for the combined pill.

Why the week of the pack decides

The combined pill works by suppressing ovulation. That suppression survives one interruption but not two close together. The break at the end of the pack is already one interruption – so a missed tablet in the first week is the dangerous one: the ovary is closest to waking up. In the third week the same mistake can simply be absorbed by skipping the next break.

What else takes away protection

  • Vomiting or severe diarrhoea: within three to four hours of taking a tablet, treat it as a missed pill – the hormone did not have time to be absorbed.
  • St John’s wort: available without prescription and one of the most reliable ways to render the pill ineffective. The same goes for some antiepileptics and for rifampicin.
  • Antibiotics: contrary to widespread belief, ordinary antibiotics do not reduce the pill’s effect. Rifampicin and rifabutin are the exceptions.
If this happens more often

Forgetting a pill is not carelessness – it is the normal failure mode of a method that demands 365 correct decisions a year. If it happens repeatedly, the answer is not more discipline but a different method: coil, implant or ring have almost the same figures for perfect and everyday use.

Compare the methods →

Sources

  1. Faculty of Sexual and Reproductive Healthcare: Combined Hormonal Contraception (Missed Pill Rules)
  2. Faculty of Sexual and Reproductive Healthcare: Progestogen-only Pills
  3. Summaries of product characteristics from the marketing authorisation holders of the individual preparations
What this tool cannot do

It works with averages. Your body does not. The result is a starting point for a conversation, not a finding – and it cannot see what an examination would show.

Questions about your result? Arrange an appointment.