Lost a birth control pill — what to do?

Originally Published: February 1, 1994 - Last Updated / Reviewed On: April 10, 2014
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ALICE!!!

If I lost a birth control pill down the sink and I just resumed with the next day's pill right away, although I will be missing one pill at the end of my 28 day cycle, is that OK? Can I just do an eight day placebo week, instead of seven, and then start my next pack like normal? Or should I start the next pack one day early? Or what?

HELP! I'm confused....

Dear HELP! I'm confused...,

Yikes! Hopefully you consulted your health care provider as well as asking Alice! about this matter. For things that you feel are urgent or need help with right away, it's always best to talk to someone right away rather than waiting for an answer from a website. If you're a Columbia student, you can contact Medical Services (Morningside campus) or the Student Health Service (CUMC).

Whenever you lose, or otherwise miss, a pill, it's best to talk with the health care provider who prescribed the pills (or someone in their medical office) about what to do. The reason is that different brands of pills have varying hormonal formulations and thus different potential effects when pills are missed. In some cases, you may be able to simply resume taking pills at your regular time the day after missing a pill and move on with life. In others cases, skipping even one pill (or extending the placebo week) could result in a serious threat to effective pregnancy prevention; it really depends on the type of pill you take. An additional factor to be aware of is that some brands of pills are multi-phasic, meaning that pills in a single pack of birth control have differing levels of hormones. Depending on which pill you missed (or which "phase" pill it was), your health care provider may have different recommendations about how to proceed.

Missing a pill (or extending the placebo week to eight days) could lessen the pregnancy prevention power of your birth control, so you may need to use a back up method for up to seven days after you've resumed your regular pill schedule. Again, your health care provider will have to check the specific guidelines for the type of pill you take to determine if you need back up. But just to be safe, you could consider using condoms or another method of contraception until you have a chance to speak with a provider.

While you need specific information from your health care provider about what to do, you may not actually need to have an in-office visit. If you can provide enough information to your provider (or one of her or his staff) over the phone, s/he may be able to give you an answer that way. You could also look for the explanatory pamphlet that comes with each pack of pills (usually a small, folded piece of paper), which may have some guidance about the brand's formulation and what to do in the case of a missed pill.

If pregnancy is a concern, you could consider taking emergency contraception (EC). Plan B One-Step and the other generic one-pill forumations of EC are available on the shelf at pharmacies and drugstores. You do not need to ask a pharmacist, provide a prescription, or proof-of-age to obtain and purchase these types of EC, which may range between $30 to $60 per dose. If you live within the five boroughs of New York City, EC is available for free, 24 hours-a-day at any public hospital. For more information, check out Emergency contraception basic information.

You're doing the right thing by reaching out for information after losing a pill; however, in this case your health care provider is your best resource. Good luck getting in touch, and take care,

Alice