3. Missed Contraceptive Pills

Missed Contraceptive Pills

This PatientPlus article is written for healthcare professionals so the language may be more technical than the condition leaflets. You may find the abbreviations list helpful.

This guidance is consistent with that issued by the Faculty of Sexual and Reproductive Healthcare.[1]

Save time & improve your PDP on Patient.co.uk

  • Notes Add notes to any clinical page and create a reflective diary
  • Track Automatically track and log every page you have viewed
  • Print Print and export a summary to use in your appraisal
Click to find out more »

If one pill is missed, anywhere in the pack

  • The last pill missed should be taken now, even if it means taking two pills in one day.
  • The rest of the pack should be taken as usual.
  • No additional contraception is needed.
  • The 7-day break is taken as normal.

If two or more pills are missed (ie more than 48 hours late), anywhere in the pack

  • The last pill missed should be taken now, even if it means taking two pills in one day.
  • Any earlier missed pills should be left.
  • The rest of the pack should be taken as usual and additional precautions (eg condom or abstinence) should be taken for the next 7 days.
  • Emergency contraception may be required if the patient had unprotected sex in the previous 7 days and they have missed two or more pills (ie more than 48 hours late) in the first week of a pack.
  • The next pack of pills may need to be started without a break, if fewer than seven pills are left in the pack after the missed pill.

When a woman realises she has missed a pill:[2]

  • She should take the missed pill as soon as she remembers and resume her usual pill-taking schedule - even if this means taking two pills on the same day, ie one when she remembers and the next pill on time.
  • In addition, if the pill is more than 3 hours late (12 hours with Cerazette®[3]) an alternative back-up method is required, eg a condom should be used (or abstinence) for the next 2 days, and consider the need for emergency contraception if there was unprotected sexual intercourse 2-3 days prior to the missed pills, or there has been intercourse since the missed pill(s).

NB: the patient requires the same advice as for a missed pill if vomiting occurs within 3-4 hours of taking a contraceptive pill.

Provide feedback

Further reading & references

  1. Missed Pill Recommendations, Faculty of Sexual and Reproductive Healthcare (2011)
  2. Progestogen-only Injectable Contraception, Faculty of Sexual and Reproductive Healthcare (2009)
  3. Summary of Product Characteristics (SPC) - Cerazette® 75 microgram film-coated tablet; Merck Sharp & Dohme Limited, electronic Medicines Compendium. December 2011.
Original Author: Dr Huw Thomas Current Version: Peer Reviewer: Dr Hannah Gronow
Last Checked: 28/09/2011 Document ID: 2460  Version: 23 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.