Missing Pills…What to do

MISSING PILLS

What can a woman do if she misses combined oral contraceptives (COCs)?

For 30-35 µg ethinylestradiol pills:

Missed 1 or 2 active (hormonal) pills or if she starts a pack 1 or 2 days late

  • She should take an active (hormonal) pill as soon as possible * and then continue taking pills daily, 1 each day.
  • She does not need any additional contraceptive protection.

Missed 3 or more active (hormonal) pills or if she starts a pack 3 or more days late

  • She should take an active (hormonal) pill as soon as possible* and then continue taking pills daily, 1 each day.
  • She should also use condoms or abstain from sex until she has taken active (hormonal) pills for 7 days in a row.
  • If she missed the pills in the third week, she should finish the active (hormonal) pills in her current pack and start a new pack the next day.  She should not take the 7 inactive pills.
  • If she missed the pills in the first week and had unprotected sex, she may wish to consider the use of emergency contraception.

For 20 µg or less ethinylestradiol pills:

  • If the woman misses 1 active (hormonal) pill or starts a pack 1 day late, she should follow the guidance above for “Missed 1 or 2 active (hormonal) pills or if she starts a pack 1 or 2 days late.”
  • If the woman misses 2 or more active (hormonal) pills or if she starts a pack 2 or more days late, she should follow the guidance above for “Missed 3 or more active (hormonal) pills or if she starts a pack 3 or more days late.”

For both 30-35 µg and 20 µg or less ethinylestradiol pills:

Missed any inactive (nonhormonal) pills

  • She should discard the missed inactive (nonhormonal) pill(s) and then continue taking pills daily, 1 each day.

*    If a woman misses more than 1 active (hormonal) pill, she can take the first missed pill and then either continue taking the rest of the missed pills or discard them to stay on schedule.

 Depending on when she remembers that she missed a pill(s), she may take 2 pills on the same day (one at the moment of remembering, and the other at the regular time) or even at the same time.

 

From the World Health Organization’s Selected Practice guidelines – 2005

http://www.who.int/reproductive-health/publications/