Missed pills and extra pills

If you're on the combined contraceptive pill and you miss a pill, what you need to do depends on: 

• how many pills you've missed (you've missed a pill when it's more than 24 hours since you should have taken it)
• when you missed your pill (where you are in the pack)
• the type of combined pill you are taking 

This advice is about all combined contraceptive pills, except Qlaira, Zoely, Eloine and Daylette. If you are using one of these types of combined pill, get advice or read the patient information leaflets that can be found on the electronic Medicines Compendium (eMC) website.

See What should I do if I miss a pill (progestogen-only pill)? for information about missed pills and the progestogen-only pill.

What if I've missed one pill?

If you've missed one pill anywhere in the pack or started a new pack one day late, you're still protected against pregnancy. You should:

• take the last pill you missed now, even if this means taking two pills in one day
• carry on taking the rest of the pack as normal
• take your seven-day pill-free break as normal or, if you're on an everyday (ED) pill, take your dummy (inactive) pills

You don't need to use extra contraception.

What if I've missed two or more pills?

If you've missed two or more pills anywhere in the pack or started a new pack two or more days late (48 hours or more), your protection against pregnancy may be affected. You should:

• take the last pill you missed now, even if this means taking two pills in one day
• leave any earlier missed pills
• carry on taking the rest of the pack as normal
• use extra contraception such as condoms for the next seven days

When you come to the end of your pill pack, after missing two or more pills:

• if there are seven or more pills left in the pack after the last missed pill – finish the pack, take your seven-day pill-free break as normal, or take your inactive pills before you start your next pack
• if there are less than seven pills left in the pack after the missed pill – finish the pack and start a new pack the next day; this means missing out the pill-free break or not taking your inactive pills

You may also need emergency contraception if you've missed two or more pills in the first week of a pack and had unprotected sex in the previous seven days.

What if I'm not sure what to do?

If you're not sure what to do:

• continue to take your pill
• use another method of contraception, such as condoms
• get advice as soon as possible

Why this advice may be different from the advice in your contraceptive leaflet

You may find the advice on this page differs from advice provided in the contraceptive manufacturer's patient information leaflets.

The information on this page is based on recommendations issued by the UK Medicines and Healthcare products Regulatory Authority (MHRA) in 2011. The recommendations are evidence-based, which means they are supported by a large amount of scientific research.

These recommendations are used in the FPA's combined pill patient information leaflet and in contraceptive guidelines for UK health professionals from the Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists, as well as in the British National Formulary, a prescribing manual for health professionals.

The manufacturer's advice may be more cautious and say there is a risk of pregnancy if you have missed one pill or a pill is taken more than 12 hours after the usual time.

Where to get further advice

You can get advice from:

• a contraception (family planning) clinic
• the FPA 
• a GP
• a pharmacist
• the NHS 24 111 service

This advice is about the progestogen-only pill (POP), or mini pill. For advice about the combined contraceptive pill, see What should I do if I miss a pill (combined pill)?

The advice for a missed POP depends on whether your pill contains desogestrel or not. You can find out if your pill is a desogestrel pill by:

• checking the packet
• checking the patient information leaflet that comes with the packet
• asking a pharmacist

Less than three hours late (or less than 12 hours late for a desogestrel pill)

You are still protected against pregnancy if:

• you're on a traditional progestogen-only pill, such as Micronor, Norgeston or Noriday, and you're less than three hours late taking your pill
• you're on a desogestrel pill, such as Cerazette or Cerelle, and you're less than 12 hours late taking your pill

What you should do:

• take the missed pill as soon as you remember
• take the next pill at the usual time
• you don't need to use extra contraception
• if you've had unprotected sex, you don't need emergency contraception

More than three hours late (or more than 12 hours late for a desogestrel pill)

You're not protected against pregnancy if:

• you're on a traditional progestogen-only pill and you're more than three hours late taking your pill
• you're on a desogestrel pill and you're more than 12 hours late taking your pill

What you should do:

• take a pill as soon as you remember – only take one, even if you've missed more than one pill
• take the next pill at the usual time – this may mean taking two pills on the same day (one when you remember and one at the usual time), this is not harmful
• carry on taking your remaining pills each day at the usual time
• use extra contraception such as condoms for the next two days (48 hours) after you remember to take your missed pill, or don't have sex
• if you have unprotected sex during the two days after you miss your pill, you may need emergency contraception – get advice from your GP or contraception clinic  

It takes two days for the progestogen-only pill to thicken cervical mucus so that sperm cannot get through or survive. The Faculty of Sexual and Reproductive Healthcare advises using extra contraception for two days after you remember to take your pill.

The patient information leaflet that comes with your pill might say to use condoms for the next seven days after you remember to take your pill. This is because it takes seven days for the pill to suppress ovulation.

Where to get advice

If you're not sure what to do, you can get advice from:

• a contraception (family planning) clinic
• FPA (formerly the Family Planning Association) 
• a GP
• a pharmacist
• the NHS 24 111 service

If you've accidentally taken one extra contraceptive pill, you don't need to seek medical advice and you won't have any symptoms.

If you've taken several extra pills, you may:

• feel slightly sick (nauseous)
• be sick (vomit) 
• have some vaginal bleeding

These symptoms will pass, and you don't need to seek medical advice unless your symptoms are severe.

If a child has accidentally taken a contraceptive pill or pills, they may also feel nauseous or vomit. If you're concerned, talk to your pharmacist or GP, or call the NHS 24 111 service.

Continue taking your pills

If you have taken any extra pills, you should carry on taking the rest of your packet as normal at the same time you usually take it each day.

For example, if you usually take your pill at 8am every day:

• on Monday, you take your normal pill at 8am, but then take an extra pill by mistake at 8.15am
• you should take your next pill at 8am on Tuesday, as normal 

Correcting the days

If you've taken an extra pill, you won't be in line with the days on your pill packet.

For example, if you've taken Monday's pill and Tuesday's pill on Monday, on Tuesday you will have to take Wednesday's pill.

You can correct this by replacing the missing pill with another pill from the same packet or a spare packet, but how you do this will depend on which type of pill you're on.

For more information on replacing a missing pill, see What should I do if I've lost a contraceptive pill?  

It's important you do not miss a pill. Missing a pill can mean you are at risk of pregnancy, depending on which pill you are taking.

Find out more:

What should I do if I've missed a combined pill?

What if I've missed a progestogen-only pill? 

If you've lost a pill, replace it with another from the same packet or one from a different packet.

How you do this depends on which kind of pill you take. For example:

• a 21-day combined pill, such as Microgynon 30 – you take a pill each day for 21 days, followed by seven days without pills when you have your period
• a 28-day or every day (ED) combined pill, such as Logynon 30 ED – you take a pill every day (the first 21 pills are active pills and the next seven are inactive or "dummy" pills) 
• a progestogen-only pill (POP), such as Norgeston – you take a pill every day

21-day combined pill

If you've lost one of these:

• take the last pill in the packet instead
• take the rest of the pills on the correct days
• you'll reach the end of your packet sooner, but this won't affect your contraception

Or, to avoid changing the day you start your next packet:

• take a pill from a spare packet to replace the one that's missing
• take all the pills as normal on their correct days
• keep this spare packet in case you lose any more pills

28-day or every day (ED) pill

You need to know which pills are active pills and which pills are dummy. If you've lost an active pill:

• take the last active pill in the packet instead 
• continue with the rest of the active pills on their correct days
• you'll reach the dummy pills sooner, but this won't affect your contraception

Or, to avoid changing the day you start your next packet:

• take an active pill from a spare packet to replace the missing one
• take all the remaining pills as normal on their correct days 
• keep this spare packet in case you lose any more pills 

If you've lost a dummy pill, you don't need to replace it. Just continue taking the remaining dummy pills on their normal days and your contraception won't be affected. You'll start your next packet on the usual day.

Progestogen-only pill

If you've lost a pill:

• take the last pill in the packet instead 
• take the rest of the pills on the correct days
• you'll reach the end of your packet sooner, but this won't affect your contraception

Or, to avoid changing the day you start your next packet:

• take a pill from a spare packet to replace the missing one
• take the rest of the pills as normal on their correct days 
• keep this spare packet in case you lose any more pills 

Getting advice

If you're taking a phasic contraceptive pill (where the amount of hormones in the pills varies throughout the pack), or you're not sure what to do, you can get advice from:

• contraception clinics (sometimes called family planning clinics) 
• pharmacists
• GPs
• the NHS 24 111 service
• FPA (formerly the Family Planning Association)