Missed Pill: Advice for the Combined Oral Contraceptive Pill (COCP)
Contraceptives are used to prevent pregnancy. The combined oral contraceptive pill (COCP) is a type of contraception for women. The COCP is sometimes referred to as just the pill. It contains two hormones, estrogen and progestin. These hormones closely resemble the estrogen and progesterone hormones produced by a woman’s ovaries. There are lots of different COCPs available. Some COCPs contain 21 pills which are followed by a seven-day break. Other COCPs contain 28 pills, with seven inactive (dummy) pills at the end of the pack. You should try to take your tablets at the same time each day. If you do not take your pill within 12 hours of your regular pill-taking time, it is classed as a missed pill. Below we will look at steps you should take if you miss any pills. Remember, the advice only applies to missed active pills. If you miss any inactive pills, you can just disregard these pills.
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What should I do if I miss one pill?
If you have missed one active pill from anywhere in the pack, you should take the pill now and take your next pill at your regular time (even if this means taking two pills on the same day). Then take the rest of the pack as usual.
What should I do if I have missed more than one pill?
If you have missed more than one pill, you should take the last pill you have missed now and take your next pill at your regular time (even if this means taking two pills on the same day). Leave out any other missed pills except the last one. Then take the rest of the pack as usual. However, if the pills were missed in the third week of the pack, you should not take a hormone-free interval (either your seven-day break or seven inactive pills). Go onto your next pack instead. You should also use condoms or avoid having sex for the next seven days. If you have missed more than seven pills in a row, you should restart the COCP. This means starting a new pack on the first day of your period.
Will I need emergency contraception?
If you have missed two or more pills from the first week of your pack and have had unprotected sex in the hormone-free interval or the first week of the pack, you should speak with your doctor or pharmacist. You may require emergency contraception.
When taking the COCP, what should I do if I vomit or have diarrhea?
Vomiting and severe diarrhea can stop the COCP from being absorbed into your body. If you vomit within three hours of taking the COCP, you should take another pill immediately. Then take your next pill at the regular time. Provided you do not vomit again, and you took your extra pill within 12 hours of your normal pill-taking time you will still be protected against pregnancy. However, if vomiting or severe diarrhea lasts longer than 12 hours, you must take extra precautions. Continue to take your COCP as usual. However, you should also use condoms or avoid having sex for the duration of your illness and for an additional seven days after the vomiting or diarrhea has stopped. If your illness occurs during the third week of your pack, you should not take a hormone-free interval (either your seven-day break or seven inactive pills). Go onto your next pack instead.
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