With a combined pill, one late or missed pill (up to 48 hours after it was due) means: take
it now and carry on, with no backup needed. Two or more missed pills (48 hours or more)
means: take the most recent one now, use condoms for the next 7 days, and skip the placebo
week if the missed pills were in the last week of hormonal pills. Progestin-only pills have
their own rules. Enter your pill type and when the pill was due, and this applies the
CDC guidance
to your case, with the dates.
Doz is a free download on the App Store:
it reminds you at your pill time every day and can follow a 21/7 pack with an on/off cycle.
It is free for up to four medications, with no account. With Doz Pro it can also nudge you
again if you have not logged the pill, and ring through Silent mode.
The CDC rules this follows
The CDC counts from when the pill should have been taken. For combined pills and for
drospirenone pills, a pill is late until 24 hours have passed and missed after that. For
norethindrone and norgestrel pills, a pill is missed once it is more than 3 hours late.
| Pill and situation | Take | Condoms or no sex | Also |
|---|
| Combined: 1 late or missed (under 48 hours) | The late or missed pill as soon as possible, then the rest at your usual time | Not needed | Emergency contraception is not usually needed |
| Combined: 2 or more missed (48 hours or more) | The most recent missed pill as soon as possible; throw the other missed pills away | Until you have taken hormonal pills 7 days in a row | Missed in the last week of hormonal pills: skip the placebo week and start a new pack. Missed in the first week, with sex in the last 5 days: consider emergency contraception |
| Drospirenone (Slynd): 1 late or missed (under 48 hours) | The late or missed pill as soon as possible | Not needed | |
| Drospirenone (Slynd): 2 or more missed (48 hours or more) | The last missed pill as soon as possible; the others stay in the pack | Until you have taken hormonal pills 7 days in a row | Missed in the first week, with sex in the last 5 days: consider emergency contraception |
| Norethindrone or norgestrel: more than 3 hours late | One pill as soon as possible, then one a day at your usual time | Until you have taken it on time 2 days in a row | Consider emergency contraception if you have had sex without a condom |
Where the CDC says to consider emergency contraception, it excludes ulipristal (ella), the
pill sold for up to 5 days after sex. The rules cover hormonal pills only, not placebo
pills.
If you are in the UK
UK guidance (FSRH) differs in a few places, and the NHS website now tells you to read your
pack leaflet or ask a pharmacist.
The main differences:
| Pill | CDC (US) | FSRH (UK) |
|---|
| Combined | Counts from when the missed pill was due: 2 or more missed at 48 hours | Counts from the last pill you took: 2 or more missed at 72 hours since it |
| Drospirenone | 1 late or missed pill: no condoms needed | Missed once more than 24 hours late: condoms for 7 days |
| Desogestrel (Cerazette and others) | Not covered | Missed once more than 12 hours late: condoms for 2 days |
| Traditional progestin-only | Missed once more than 3 hours late: condoms for 2 days | Missed once more than 3 hours late: condoms for 2 days |
The calculator uses the CDC rules. If you get your pills in the UK, follow your leaflet and
your pharmacist.
So it does not happen again
Most missed pills are forgotten. A reminder at the same time every day helps, and so does
keeping the pack next to something you use every day. If you are still
working out when to begin, the birth control
start calculator shows when a new pack protects you, and
this guide to birth control reminder apps
compares the options.
Sources
Common questions
What do I do if I missed one birth control pill?
With a combined pill, take the missed pill as soon as you remember, then carry on at your usual time, even if that means 2 pills in one day. If it is less than 48 hours since it was due, the CDC says no backup contraception is needed. Progestin-only pills differ: a norethindrone pill more than 3 hours late needs condoms for 2 days.
What if I missed 2 birth control pills?
With a combined pill, take the most recent missed pill now and throw the other one away, then carry on at your usual time. Use condoms or avoid sex until you have taken hormonal pills for 7 days in a row. If the missed pills were in the last week of hormonal pills, skip the placebo week and start a new pack.
Do I need emergency contraception after a missed pill?
For one late or missed combined pill, usually not. The CDC says to consider it, other than ulipristal (ella), if 2 or more combined or drospirenone pills were missed in the first week of the pack and you had sex without a condom in the previous 5 days, or if a norethindrone pill was missed and you had sex without a condom. A pharmacist can advise.
Is a pill taken 12 hours late a missed pill?
For a combined or drospirenone pill, no: under 24 hours it is a late pill. Take it now and carry on, with no backup needed. For a norethindrone or norgestrel pill, yes: anything more than 3 hours late counts as missed.
One thing this cannot do
This is an arithmetic tool, not medical advice. It works out numbers from what you type
in — it does not know your medication, your prescription, or what you should do
if something goes wrong. Anything about changing a dose, spacing doses differently, or
handling a missed dose is a question for your doctor or pharmacist.