What if I miss one or more combined pills?

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In order for the pill to be most effective it is important to take it every day at around the same time, but can be taken several hours before or after this time without significantly effecting coverage. A woman has only truly ‘missed a pill’ if it is taken more than 24 hours later than her regular time. Even if a woman misses a pill, the important thing is not to stop taking the pills. Missing one pill anywhere in the pack or starting the new pack one day late is not a problem. Women will still have contraceptive coverage. Missing two or more pills or starting the pack two or more days late may affect the contraceptive coverage and effectiveness.                      

If only 1 pill is missed then a woman should take it as soon as she remembers it and continue to take her pills normally and no additional method is needed. If more than 24 hours has passed since she missed her pill she should take 2 pills.

If 2 or more pills are missed (last pill was taken 48h ago or more) then a woman should:

  • Take 2 pills immediately (the one that was missed and the one that should be taken normally on the day that she remembers).  If the package has 7 or more pills left, she should continue taking the pill as usual.
  • If her package has less than 7 pills, a woman should  finish the pack and begin a new one the next day, without taking the usual  7 days break between packages.
  • If  a woman misses 2 or more pills, than she should use condoms or abstain from sex for the next 7 days (9 days if she is taking estradiol valerate/dienogest pill), because she is not protected.

Additional precautions if 2 or more pills are forgotten according to the week of intake of the pill:

  • If 2 or more pills are missed in the first week (Pills 1–7), than Emergency Contraception  should be used if unprotected sex occurred during the pill-free interval or in the first week of pill-taking. Women should use condoms or abstain from sex for the next 7 days (9 days if she is taking estradiol valerate/dienogest pill) to avoid an unwanted pregnancy.
  • If 2 or more pills are missed in the second week (Pills 8–14) and in the first week the woman used the pills regularly for 7 days, she doesn’t need to use Emergency Contraception but should use condoms or abstain from sex for the next 7 days (9 days if she is taking estradiol valerate/dienogest pill) to avoid an unwanted pregnancy.
  • If pills are missed in the third week (Pills 15–21) and in the second week the woman used the pills regularly for all 7 days, she doesn’t need to use emergency contraception either but should use condoms or abstain from sex for the next 7 days (9 days if she is taking estradiol valerate/dienogest pill) to avoid an unwanted pregnancy. She is also advised to finish the pack and begin a new one the next day, without taking the usual  7 days break between packages.

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