Missed Contraceptive Pills

oPatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.

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

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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.

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.

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.

Original Author:
Dr Huw Thomas
Current Version:
Peer Reviewer:
Dr Hannah Gronow
Document ID:
2460 (v23)
Last Checked:
28/09/2011
Next Review:
26/09/2016