Missed your birth control pill? Here's what to do

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on July 28, 2025.

What should I do if I miss taking my birth control pill?

If you miss one or more pills, it's best to read the specific instructions in your product information or call your heath care provider or pharmacist for directions. You can also search for your specific birth control pill here. Look for the section in the patient package insert that addresses what to do for "missed pills".

There are many different types of birth control pills, with different instructions for late or missed pills, or you may need to use emergency contraception, so it's best to look at your specific pill instructions.

IMPORTANT NOTE: Any time you are not sure what to do when you have a missed a pill, use a back-up non-hormonal birth control (like a condom or other barrier method) EVERY time you have sexual intercourse. Contact your healthcare provider right away for directions.

Always use a condom (or other barrier method) to protect against sexually transmitted infections (STIs) each time you have sex.

If at any time you aren't sure what to do, call your healthcare provider or pharmacist right away for more advice.

Overview

Hormonal contraceptives like the pill are the most commonly used type of birth control. Pills that contain both an estrogen and progestin are called combined oral contraceptives (COCs). Ethinyl estradiol is a common estrogen and norethindrone, norgestimate, or drospirenone are examples of progestins found in COCs. Pills with only a progestin, like norethindrone or norgestrel are called progestin-only pills (POP) or "mini-pills".

Combined oral contraceptive (COC) pills (estrogen + progestin)

If you've missed one COC pill

In general, if you forget to take one of your combined oral contraceptive (COC) pills and it's been less than 48 hours since your missed pill, you should take it as soon as you remember. Take your next pill at the normal time. This may mean that you will take two pills in the same day. Continue taking your pills as prescribed.¹¹

A 7-day back-up method such as a condom or other barrier method is not usually needed if it's been less than 48 hours. But if it's been longer than 48 hours since you last took a pill, or you missed 2 pills in a row, you need to use a non-hormonal back-up method (like a condom or other barrier method) every time you have sex for 7 days in a row.¹¹

Emergency contraception (like Plan-B One Step) is not usually needed if you missed one pill in less than 48 hours, but you may want to use emergency contraception (EC) if you've had sexual intercourse since you missed your pill or pills. Consider EC use if pills were missed in the first or last week of the pack. You can get EC pills from the pharmacy or health clinic. The sooner you take EC, the better it works. You can get EC from a clinic or drugstore.¹ 

Do not use ella (generic name: ulipristal acetate) as an EC because the active ingredient in ella may counteract the progestin in oral contraceptives.

If you've missed two or more COC pills

If you have missed 2 or more combined oral contraceptive (COC) pills in a row (more than 48 hours late), take the last pill you missed right away. Discard any other missed pills. Continue taking the rest of the pills in your pack at the normal time, even if it means taking two pills on the same day.

Use a non-hormonal back-up method of birth control, such as a condom or other barrier method, each time you have sex until you have a taken a pill for 7 days in a row. Or abstain from sexual intercourse until one hormonal pill has been taken for 7 days in a row.

If pills are missed in the last week of your pack (for example: days 15-21 of a 28 day pack) omit the hormone-free interval by finishing the hormonal pills in the current pack and starting a new pack the next day. If you can't start a new pack right away, use a barrier method or don't have sexual intercourse until hormonal pills from a new pack have been taken for 7 days in a row.^11,18

Consider using emergency contraception (EC) if hormonal pills were missed during the first week of new pack and unprotected sexual intercourse occurred during the previous 5 days.^11,18 Emergency contraceptive may also be considered at any other appropriate time.

Do not use ella (generic name: ulipristal acetate) as an EC because the active ingredient in ella may counteract the progestin in oral contraceptives.^{References: 1,2,3,11,13,15,18,19,24}

Other information for COCs

Important Note: If you take Natazia (dienogest and estradiol) and you have missed any pills, follow the patient instructions for missed pills under "What happens if I miss a dose?" in the Natazia product information or contact your healthcare provider.

Go to the clinic or your healthcare provider for emergency contraceptive options like the copper IUD.¹ 

If you do not get your period when you expect it to occur, take a pregnancy test and contact your doctor or clinic.¹

Be sure you have another kind of non-hormonal birth control (such as condoms or other barrier method) ready at all times as a back-up in case you miss any pills. You might also consider buying emergency contraceptive pills ahead-of-time in case you need it.¹

Progestin-only pill (POP) or mini-pill

If you've missed (or are late) for one or more progestin-only pill (POP) or mini-pill

If you've missed one or more progestin-only pill (norethindrone or norgestrel pill) by more than 3 hours, take one pill as soon as possible. Continue taking pills daily, one each day, at the same time each day, even if this means taking 2 pills on the same day. 

Use a barrier method like a condom each time you have sexual intercourse until you have taken your pills correctly, on time, for a full 2 days (48 hours) in a row. ^{References: 1,5,16,19,20}

Consider the use of emergency contraception (except for ulipristal [brand name: ella]) if you have had unprotected sexual intercourse.

Do not use ella (generic name: ulipristal acetate) as an emergency contraceptive because the active ingredient in ella may counteract the progestin in oral contraceptives.

Important Note: Slynd is a a newer type of progestin-only pill (POP) that contains drospirenone instead or norethindrone or norgestrel. It's effective for up to 24 hours (instead of 3 hours) in the event of a delayed or missed pill. However, it's always best to take your pill at the same time each day to help you stay on track. View instructions here on what to do if you miss one or more pills from your Slynd packet.

Other information for POPs

Progestin-only pills (POPs or the "mini-pill") are often recommended for women who are breastfeeding and women who cannot use the combined oral contraceptive pill (with both estrogen and progestin) for medical reasons.

You might find the progestin-only pills a little trickier to use than combined hormonal birth control pills because the progestin-only pill MUST be taken at the same time each day (no more than 3 hours late). You could become pregnant if you miss taking your progestin-only pill (mini-pill) by more than 3 hours. If you miss taking one mini-pill by 3 hours, follow the guidelines below.

Examples of progestin-only pills with norethindrone include: Camila, Errin, Heather, Jencycla, and Lyza.

In July 2023 the U.S. Food and Drug Administration approved Opill (norgestrel) the first nonprescription, over-the-counter (OTC) birth control pill (oral contraceptive). Opill, a progestin-only ("mini") pill, is now available online, on pharmacy shelves and at other retailers as of March of 2024. If you have questions about Opill, ask your pharmacist or doctor.

Learn more: What is Opill, where can I get it and how much does it cost?

Extended cycle or continuous cycle pills

Missed Pill for Extended Cycle Birth Control Pills

Follow the directions in the product label of your birth control if you miss one or more pills from an extended-cycle pack. If you are not sure which pills are active or inactive, review your patient package insert that comes with your prescription and ask your pharmacist or doctor.

More and more women are using extended-cycle pills to avoid the inconvenience of a monthly period. Extended-cycle packs have 84 active tablets and 7 inactive (or low-dose estrogen) tablets (13 weeks) and result in only four periods per year. Taking low-dose estrogen in the last 7 pills helps to reduce side effects like bleeding and bloating linked with a hormone-free interval.¹⁸

It is important that you take your pill each day at the same time. All extended-cycle packs have the same general directions for missed pills, but it is important you know which color pills are active and which pills are inactive in your pack. 

Examples of extended-cycle birth control pills include: Amethia, Amethia Lo, Camrese, Daysee, Introvale, Jolessa, LoSeasonique, Quartette, Rivelsa, Seasonique, and Seasonale.

How effective is the pill?

Even if you take the pill exactly as you are supposed to every day, it still isn't perfect. The incidence of pill failure resulting in a pregnancy is roughly 1% to 2% per year (1 to 2 pregnancies per 100 women) even if it's taken perfectly every day as directed. 

In the real world, the average effectiveness of the pill is about 93% (7 pregnancies per 100 women) including women who do not always take the pill exactly as directed - even if they still take their pill each day.¹ For example, some pills like progestin-only pills (POPs) need to be taken within a 3 hour window each day to work best. 

Your chances for getting pregnant if you missed a pill depends upon when you missed your pill during your ovulation cycle, the number of pills you missed in a row, and if you had unprotected sex around the time of missed your pill(s).

The highest risk of ovulation and pregnancy occurs when the hormone-free interval (the time when inactive pills are taken or there is a break between active pills) is prolonged for more than seven days. This can occur by either:

• delaying the start of your birth control pack, or
• by missing active pills during the first or third weeks of pill use.

Certain drug interactions can also lower the effectiveness of the pill. Always double check for any interactions with your pharmacist or doctor. Tell them about all of the medicines you use, including prescription, over-the-counter (OTC), herbal supplements or vitamins.

What should I do if I keep forgetting my pill?

Forgetting to take birth control pills is a major reason for unintended pregnancies. Birth control pills work best if taken according to schedule and at the same time each day. If you miss one or more pills, you increase your chances of releasing an egg that could be fertilized and lead to a pregnancy.

If you find that you frequently forget to take your pill, it may be better off using another form of birth control (such as an IUD, implant, shot, vaginal ring or patch). Speak to your healthcare provider about other available birth control options that do not require a daily schedule for you to remember.

Directions on what to do if you miss a pill can vary between different brands of birth control pills. It is always best to review the specific instructions in your Patient Information Handout and speak to your health care provider about your individual case. The directions below are for general use from clinical guidelines and may not apply specifically to your pill.

Always use a condom (or other barrier method) to protect against sexually transmitted infections (STIs) each time you have sex.

Emergency contraceptives 

If you have missed a pill and had unprotected sex, your healthcare provider may recommend that you use an emergency contraceptive (EC). Know that even if you use EC, there is still a chance you could become pregnant even if you follow the instructions exactly. 

You can use a levonorgestrel emergency contraceptive (EC) pill such as Plan B One Step, Next Choice One Dose, My Way, or similar products for up to 72 hours (3 days) after unprotected sex, but it works better the sooner you take it, so do not delay. EC is not intended to be used a routine form of birth control

Although the manufacturers state that EC pills should be used for up to 72 hours after unprotected sex, many guidelines and Planned Parenthood state they are effective up until 5 days, but effectiveness may decline over this time. So the sooner you take EC, the better it will work.

Talk to your doctor about using ella (generic name: ulipristal acetate) as an EC because the active ingredient in ella may counteract the progestin in oral contraceptives.

Where do I get emergency contraceptives?

These products are available over-the-counter (OTC) in the U.S., but speak to your pharmacist if you cannot find it on the shelves. In the U.S., these are available without age restrictions to women and men.

You can purchase over-the-counter (OTC) EC pills ahead of time so that you always have them if needed. Search for available EC here and talk to your pharmacist about available options.

You may consider buying and keeping an emergency contraceptive product at home or with you if you think you my need it but have trouble getting it. Be sure to check expiration dates.

You can read more information about Emergency Contraceptives available in the U.S here.

Does ella require a prescription?

Yes, ella (ulipristal) is a prescription emergency contraceptive pill that may be used for up to 5 days after unprotected sex or a contraceptive failure. Contact your doctor for a prescription.

• ella can make hormonal contraception like birth control pills, injections, implants, skin patches, and vaginal rings less effective. 
• After taking ella, you should use a barrier form of birth control (condom or diaphragm with spermicide) at least until your next menstrual period.⁹
• After ella use, start or resume hormonal contraception no sooner than 5 days after the use of ella.

Both ella and hormonal birth control may be less effective when used at the same time. You will need to use a barrier form of birth control until your hormonal birth control takes effect.

Being overweight or obese may lower how well some EC pills work to prevent pregnancy, although recent studies suggest weight may not be a factor.²¹

Can IUDs be used as emergency contraception?

Certain intrauterine devices (IUD) may also be used as an emergency contraceptive, but this requires a doctor visit for insertion. Intrauterine devices (IUDs) are the most effective EC method.

If you are overweight or obese, you may want to consider having an IUD inserted. IUDs for EC are very effective in women of any weight.²¹ Talk to your doctor about your best option.

The copper IUD (Paragard) can be expensive if you don't have insurance, but it can last for up to 10 years.^13,21 It should be inserted within 5 days of unprotected sex.

Additional warnings

Birth control pills do not protect from sexually transmitted infections (STI), such as HIV (AIDS) or gonorrhea. A condom or other barrier method should be used in addition to the birth control pill if protection from sexually transmitted infections (STIs) is needed.^1,2

If you have vomiting or diarrhea for any reason, your pills may not work as well because they may not be adequately absorbed into your bloodstream. Use a nonhormonal backup method (such as a condom or other barrier method) until you can contact your healthcare provider for more advice.

Cigarette smoking increases the risk of serious cardiovascular events (heart attack, stroke, blood clots, or developing high blood pressure) from combined oral contraceptive use. Women who are over 35 years old and smoke should not use combined oral contraceptives.

Ask your pharmacist for a drug interaction review each time you start a new medication or a new type of birth control. Certain medications may interfere with the absorption of your birth control pills.

This is not all the information you need to know about birth control for safe and effective use and does not take the place of your doctor’s directions. Review the full instructions that come with your birth control product and discuss this information and any questions you have with your doctor or other health care provider.

See also

• Birth Control Pills - When Should I Expect My Period?
• Birth Control Pills: Benefits, Risks & Side Effects
• Birth Control Pills: Why do I get breakthrough bleeding?
• Emergency Contraception: What You Need to Know
• Emergency Contraceptives: Morning After Pills & OTC Options
• Grapefruit and Birth Control Pills: Your Questions Answered
• Non-hormonal Methods of Birth Control
• What are the options for permanent birth control?
• Your Guide to Types of Birth Control Pills (Oral Contraceptives)

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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