The following section details what to do if you make a mistake in how you take your pill. Most importantly, remember that each specific pill brand is different, and the following is how most pills generally advise you to handle errors. Your specific pill might have different instructions, which is why it is so important for you to read the patient insert that comes with your specific pill pack. If you want more specific help, you can use this quiz from Planned Parenthood which can guide you to more information
WHAT IF I…
Took my pill late?
“Late” means you took your pill within 24 hours of when you were supposed to take it. Taking your pill at 8 pm when you were supposed to take it at noon and taking your pill at 8 am when you were supposed to take it at noon are both examples of late pills.
If at any point in the month you suddenly realize you’re late taking your pill, take your pill as soon as you remember, and then take your next pill at the right time, even if you must take two pills in one day. If you’re supposed to take your pill at noon, but you only remember the next day at 8am, take yesterday’s pill at 8am and today’s pill at noon. Don’t stress—you’re still fully protected from pregnancy. Try not to make this a habit though, because “perfect use” means you take almost all of your pills at the right time.
Missed a day?
“Missed” means you took your pill more than 24 hours when you were supposed to take it. Taking your pill at 2 pm on Tuesday when you were supposed to take it at 9 am on Monday is a missed pill.
If at any point in the month you suddenly realize you missed a pill, take the one you missed as soon as you remember, and then take your next pill at the right time, even if you have to take two pills in one day. If you’re supposed to take your pill at noon, but you only remember the next day at 2pm, take yesterday’s pill at 2pm and today’s pill at noon. Don’t stress—you’re still fully protected from pregnancy. Try not to make this a habit though, because “perfect use” means you take almost all of your pills at the right time.
Missed multiple days?
“Missed” means you took your pill more than 24 hours past when you were supposed to take it. Missing multiple days means you didn’t take a pill for 48 hours or more.
If you miss multiple pills in a row, you should take the most recent pill you missed (ie, the pill you were supposed to take in the last 24 hours). Then, if necessary, take today’s pill, even if you end up taking two pills in one day. Throw all the other pills you missed out and take the rest of the pill pack as normal.
Example:
You take the first pill of the week on Sunday at 5 pm and take it correctly on Monday and Tuesday. If you realize on Friday at 8 am that you didn’t take your pill on Wednesday or Thursday, you should take Thursday’s pill at 8 am. Then, at 5 pm like normal, take Friday’s pill, and throw out Wednesday’s pill. Take Saturday’s pill at 5 pm and continue taking your pack as you normally would.
In the picture below, the star represents every pill you would take on Friday, the X shows the pills you would throw out, and the circles are the pills you took correctly. This is true no matter which week you’re on.
HOWEVER, missing pills has different consequences depending on the week.
Your body releases an egg (ovulates) when you’re at a very specific, very low hormone level. When hormones dip below that specific level, your body takes that as a sign to ovulate. Taking the pill keeps your hormonal levels high enough that your body never ovulates. Therefore, you can never go longer than 7 days without taking the pill, because your hormone levels might get low enough that your body ovulates.
In a lot of combination pill packs, the pills in the last (4th) week are hormone-free placebo pills. This is why the 1st week of pills is so important; these pills contain the first hormones you receive after seven days of no hormones. This is also why the 3rd week is also important— if you don’t take the last pill of the 3rd week, you won’t have hormones for 8 days. Keep reading for specific instructions for each week.
If you miss pills in the First Week
You are not protected from pregnancy until you take the pill correctly seven days in a row. During these seven days, you must use another form of contraception (like condoms) or choose not to have sex.
If you miss multiple pills during the first week and have unprotected sex, the CDC recommends taking a morning-after pill. Read more about how to get them below.
If you miss pills in the 2nd Week:
You are not protected from pregnancy until you take the pill correctly seven days in a row. During these seven days, you must use another form of contraception (like condoms) or choose not to have sex.
You do not have to take a morning-after pill. However, as discussed HERE, it can be a smart move if your state has particularly poor abortion access, or if you also missed pills during the 1st week. It depends on your priorities; if you have the money, it might be worth it to take a Plan B for your peace of mind.
If you miss pills the 3rd week:
You are not protected from pregnancy until you take the pill correctly seven days in a row. During these seven days, you must use another form of contraception (like condoms) or choose not to have sex.
You do not have to take a morning-after pill. However, as discussed HERE, it can be a smart move if your state has particularly poor abortion access, or if you missed earlier pills. It depends on your priorities; if you have the money, it might be worth it to take a Plan B for your peace of mind.
The day after you finish week 3, you must take pill 1 of your next pack. You cannot take the 7 placebo pills at the end of the pack/ wait 7 days and get your period. You must skip your period and immediately start the next pack in order to keep your hormone levels high enough to stop ovulation.
If you miss pills in the 4th Week: If you’re taking combination pills, the pills in your 4th week are hormone-free. So it doesn’t matter if you skip some! Just be careful to remember to start your next pack on the right day even without the pills to take as a reminder.
What if I took a pill out of order?
This primarily depends on your pill pack and which pill you took instead of the right one.
If you…
Took one of the hormone-free pills in the 4th week instead of the correct pill, then think about this as a missed or late pill. If you realize immediately, simply take the correct pill. If you realize within 24 hours, count this as a late pill (see “Took My Pill Late” above for instructions). If you realize after 24 hours, count this as a missed pill (see “Missed a Day.”)
Took the wrong pill but all the pills in your pack are the same color, don’t sweat. This means that all the pills in your pack contain the same hormones, so you haven’t caused any harm by messing with the order. Tomorrow, take the pill you should have taken today, and keep taking your pills normally from there.
Took the wrong pill and every week in your pack is a different color, it depends on which wrong pill you took. If you took another pill within your week, you’re fine, since the whole week of pills contains the same hormones. Tomorrow, take the pill you should have taken today, and keep taking your pills normally from there. If you took a pill from a different week, you might want to consider backup contraception for seven days, especially if you took the wrong pill during week 1. Tomorrow, take the pill you should have taken today, and keep taking your pills normally from there.
What if I started my pill pack late?
Depending on whether you’re choosing to get your period, there should either be exactly zero or seven days between when you take the last pill of your last pack and the first pill of your next pack.
If you choose to skip your period, you should be taking the first pill of your next pack immediately after the last pill of your third week. If you accidently forget to take the first pill of the next pack, go ahead and wait six more days before you take it. You will unfortunately get your period, but you will resync your pill schedule and will remain fully protected from pregnancy.
If you choose to get your period, you should be taking the first pill of your next pack seven days after you finish the last pill of the third week.
If you start a pack one day late, take the first pill as soon as you remember. It’s okay to take the first pill and second pill on the same day. If there were only eight days between the last pill of your last pack and the first pill of this one, you’re still fully protected from pregnancy.
If you start a pack two or more days late, take the last pill you were supposed to take as soon as you remember. For instance, if you were supposed to start pill 1 on Sunday but only remember on Tuesday, take Tuesday’s pill (pill 3) and throw pills 1 and 2 out. Take the rest of your pills as normal. You are not fully protected from pregnancy. Because the hormones in the first week of pills stop you from ovulating, starting a pack late means your body might release an egg, which could be fertilized by any sperm that reaches it. Therefore, you must use a backup form of contraception (like condoms) for at least seven days after you start taking the pill correctly. In the South, it’s intelligent to use a backup form of protection until you finish the entire pill pack. If you had unprotected sex up to seven days before your missed pills, you should consider taking a Plan B, since the sperm from those sexual interactions may still be alive inside of you, and there is a real chance you may release an egg that those sperm could fertilize. (Read more in the Plan B section if you’re unsure).
What if I lose a pill?
If you drop your pill down the sink (or lose it in some other ridiculous, tragic way), don’t panic. Just take the next pill in the pack— Wednesday’s pill if you lost Tuesday’s, Friday’s if lost Thursday’s, etc. The only effect this will have is finishing the pack a day early, but because you’ve still taken a pill every day, you’re still fully protected from pregnancy. Once you finish the pack a day early, take the first pill in the next pack after the normal number of days/ after a normal length gap.
For example, you might usually have a zero day gap between your last pill on Saturday and your first pill on Sunday. If you take your last pill on Friday because you lost a pill earlier, you should still have a zero day gap, so take the first pill on Saturday.
Or, if you usually have a seven day gap, you might normally take your last pill on Saturday and your first pill the next Sunday. If you finish your pack early on Friday, you should take your first pill next Saturday.
What if I lose my pill pack?
As soon as you realize, call your pharmacist. Be prepared though: the replacement pill pack they give you might cost money (probably around 45$), because insurance only covers one pack a month.
If you can cover the cost of the new pack, take the pill number you were meant to take that day. For example, if you realize you lost your pack on Wednesday of the second week and get a new pack that day, take Wednesday’s pill out of that pack. However, if you lose your pack on Wednesday and only get a new pack on Thursday, take Wednesday’s pill, wait four hours, and take Thursday’s. You’re still fully protected from pregnancy. Take the rest of the pack as normal. If you lose your pack on Wednesday and get a new pack on Friday or later (ie, more than 48 hours later), take only Friday’s pill (or Saturday’s pill if you got the pack on Saturday, etc). Because you missed two or more pills, you are not fully protected from pregnancy, and should use condoms for at least seven days after you start taking your pill correctly.
If you want more information about what to do about missed/late pills, scroll up to “Missed a Day” and “Missed Multiple Days.”
If you can’t cover that much money, don’t worry. You’ll be able to get pregnant as soon as you stop taking the pill, but you’ll be protected again as soon as you start next pack. Set an alarm on your phone to be sure you take the first pill of the next pack on the right day, and be sure to use condoms (or don’t have sex) until you start your new pack.
What if I vomit?
This is a big one. If you think about it, you probably rarely imagine yourself getting sick enough to puke. But remember—puking due to alcohol counts too. If you reliably end up “pulling trig” (or vomiting) when you drink, try taking your pill in the mornings, because puking within two hours of taking your pill means it hasn’t been absorbed possibly.
It’s worth noting that the CDC has ultimately suggested that puking any number of times for less than 48 hours does not require re-taking another pill and also does not require you to start wearing condoms/using additional contraceptives. (Though they do believe that emergency contraception (like Plan B) can be considered “when appropriate.”) However, a lot of other sources (including the NHS) report that vomiting within two hours is the same as not taking the pill at all, and suggest taking another dose.
Because the goal of this site is absolute protection for people who lack reproductive healthcare, I recommend taking the cautious route and treating vomiting like a birth control mistake. However, if your circumstances allow you to be slightly more relaxed about pregnancy, feel free to follow the CDC’s more moderate advice found here.
If you vomit within two hours of taking your pill, take the next pill in the pack. For instance, if you take Friday’s pill and puke an hour later, immediately take Saturday’s pill. Then, take the rest of your pills as normal. You’ll finish the pack a day early, but you’re still fully protected from pregnancy. If you’re confused, scroll up to see the “What If I Lost a Pill?” section.
If you are vomiting for more than 24 hours, think of it as missing multiple days (scroll up to see more). Try to keep taking your pills at the normal time. You are not fully protected from pregnancy, so you must be careful, especially if you’re early in your pill pack. Use condoms/other contraception for 7 days until after you feel better. For instance, if you start vomiting on Friday and only stop on Tuesday, you need to use condoms starting on Friday and continuing until next Wednesday.
If the pills themselves are what’s making you vomit, try eating something right before you take your pill every day. Lining your stomach with something carb-heavy (think breads, crackers, or pastries) can help avoid nausea.
What if I have diarrhea?
Much like the issue of vomiting, the CDC ultimately says that only diarrhea for more than 48 hours should affect your pill. However, other sources disagree, so you should decide for yourself how you feel about a very slight possible decrease in protection.
As mentioned, because the goal of this site is absolute protection for people who lack reproductive healthcare, I recommend taking the cautious route and treating excessive diarrhea like a birth control mistake. However, if your circumstances allow you to be slightly more relaxed about pregnancy, feel free to follow the CDC’s more moderate advice found here.
If you have diarrhea within 2 hours of taking the pill, you may want to take another pill. This is the same as losing a pill (scroll up to see more). As long as you don’t have diarrhea again, you should be fully protected from pregnancy. than 3x in 24 hours, you’re fine. Your pill’s efficacy hasn’t been affected. Try to eat something to settle your stomach.
If you’re having diarrhea for a period longer than 24 hours, then your pills might not be being absorbed properly. Keep taking your pill as normal, but be sure to wear condoms every time you have sex, beginning when the diarrhea first started and only stopping seven days after your diarrhea has stopped.
It’s also normal if your pill causes diarrhea. Much like with vomiting, diarrhea can be avoided by eating something carb-heavy (like breads or crackers) right before you swallow your pill.
What if I start taking antibiotics?
It’s a common misconception that antibiotics impact your pill’s efficacy. Obviously, you should check which medications interact with your specific pill type, but in general, almost all antibiotics don’t impact your pill. However, some medications do worsen birth control’s effectiveness, including
The antibiotic Rifampin, which is primarily prescribed to treat tuberculosis. This means the antibiotic you’re taking for your UTI, sinus infection, or chest cold won’t affect your pill.
Some herbal supplements, like St. John’s wart, which some people use to help them sleep.
In general, almost every medication you take will not affect your pill’s effectiveness. However, if you take medication for a chronic disease (like HIV, diabetes, etc), check to see how it interacts with your specific pill
In the South, I advise you to check how every new prescription you take interacts with your pill, just in case; on websites like Drugs.com, you can look up the name of your pill and check on the “Drug Interactions” tab to see if your new medication is on there. Be sure to tell your doctor that you’re on the pill, so they can watch out for bad combinations when prescribing new medications.
If you take a medication that interacts poorly with your birth control, be sure to use a backup form of contraception (like condoms) starting from the first day you take the new medication until seven days after you stop taking the medication. Take your pill normally the whole time.