What to do about a missed pill
Some simple rules to follow when you forget to take the Pill
The rules for what to do when you forget to take your contraceptive pill are different depending on the type of pill you take. Missing a pill won’t necessarily lead to an unwanted pregnancy, as long as you follow the advice that comes with your specific pill.
If you’re ever unsure about what to do after a missed pill, get some advice from your online doctor, GP, nurse, pharmacist or local sexual health clinic. Keep taking your pill, and use an additional barrier method (like condoms) for the next 7 days.
What should you do if you forget to take the Pill?
It depends on the type of contraceptive pill you’re on. There are three different types:
- the combined oral contraceptive pill (COC)
- the progestogen-only pill (POP)
- 28 day “phasic” combined contraceptive pills, such as Qlaira, Zoely, Eloine and Daylette
COCs contain versions of two naturally occurring hormones: oestrogen and progestogen. POPs contain progestogen-only and are also called mini-pills. 28-day “Phasic” combined contraceptive pills contain the same two hormones as in COCs, but the amount of these hormones in your pills changes as you go through the pack.
Missing a dose of a COC
If you miss one pill, anywhere in the pack, or you start a new pack a day late, you’ll still be protected against unwanted pregnancy.
- take your missed pill as soon as you can, even if it means taking two in one day
- carry on taking the rest of your pack as normal
- have your 7-day break as normal, or take your 7 inactive pills if you’re on an everyday pill
You won’t need to use extra contraception.
Missing a dose of a POP
The advice here is slightly different because different brands of mini pill contain different hormones.
Some POPs contain the hormone desogestrel, and some don’t. You’ll be able to find out what your pills contain by reading the patient information leaflet that comes in your packet.
If you’re late for a mini pill, you’ll still be protected against pregnancy if:
- you’re less than 3 hours late for a traditional POP (like Noriday, Micronor or Norgeston)
- you’re less than 12 hours late for a desogestrel pill (like Cerelle or Cerazette)
In these cases, you should:
- take your missed pill as soon as you can
- carry on taking your next pill as normal
You don’t need to use any extra contraception. And if you’ve already had unprotected sex, you don’t need to take emergency contraception to avoid unwanted pregnancy.
If you’re more than 3 hours late (for a traditional POP), or 12 hours late (for a desogestrel pill), you won’t be protected against unwanted pregnancy. You should:
- take your missed pill as soon as you can, and then take your next usual pill on the day you’re meant to, even if this means taking two pills on the same day
- carry on with the rest of your packet as usual
- use an extra method of contraception (like condoms) for the next 2 days if you have sex
If you’re unsure about what to do, talk to a medical professional for advice straight away.
Missing a dose of 28-day phasic pills
If you are taking Qlaira, Zoely, Eloine or Daylette, the pill rules are different. This is because of the different levels of hormones in the pills in your pack. With these pills, whether you have missed one pill or more, you should always check the patient information leaflet for more specific advice about what you should do next. This will depend on how many pills you have missed and where in the pack you got up to when you missed them.
What if I miss two pills or more?
If you’ve missed two pills or more, with any pill, then your protection against pregnancy will be affected.
With COCs, you should:
- take the pill you missed last now, even if this means taking 2 in one day
- carry on with the rest of your packet as normal
- use an extra method of contraception (like condoms) for the next 7 days
Follow the instructions on your patient information leaflet specific to your pill about how you start your next pill packet.
For POPs, you should:
- use an extra method of contraception (like condoms) for at least 2 days
- think about getting advice for emergency contraception. You might want to do this if you’ve already had unprotected sex in this period, and if this type of contraception is right for you
Always follow the instructions for your specific pill – you’ll find them in the patient information leaflet in your pill packet. Taking a pregnancy test and/or talking to a doctor can help if you’re unsure.
For 28-day phasic pills:
- Follow the instructions in your patient information leaflet
- Advice on what to do will depend on where in your course the pills were missed
What if you miss a pill and then have unprotected sex?
If you miss a pill and then have unprotected sex, you’ll be at a slightly higher risk of pregnancy. But this will depend on the type of pill you take, how long it’s been since you missed the pill, and how many pills you’ve missed.
If you still have concerns, you should get medical advice from a nurse, pharmacist, GP or someone from your local sexual health clinic. They may recommend that you take a pregnancy test and that you get tested for STIs.
Can you get pregnant if you miss one pill?
No one type of contraception is 100% foolproof. There’s a small possibility that you could get pregnant even if you never miss a pill.
But, your chance of getting pregnant does go up slightly when you miss a pill because this will make the pill slightly less effective.
Can you take the Pill late if you forget it?
Again, this depends very much on the type of pill that you take. Your patient information leaflet will have specific advice on whether you can take the Pill late when you forget it. In a few cases, you’ll be advised to wait until the next day before taking a missed pill.
See the “What should you do if you miss the pill” section above for more information.
What actually happens when you miss a pill?
Whenever you miss a pill, your body will experience a slight drop in hormone levels from when you’re taking your pills correctly.
The contraceptive pill works by using these hormones to change certain things in your body, making pregnancy unlikely. So, a drop in these hormone levels can stop the pill working as well as it should
It’s also possible that you’ll get side effects because of missing a pill, including:
- spotting or irregular bleeding between periods (if you have them – some pills will stop your period entirely)
- mood swings
However, each pill only contains a small amount of these hormones. So in many cases, it’s unlikely that missing one pill will cause anything unexpected, as long as you follow the recommended steps from then on.
NHS Inform (2018). Missed pills and extra pills. [online] Available at: https://www.nhsinform.scot/healthy-living/contraception/the-pill/missed-pills-and-extra-pills [accessed 19th December 2018].