Forgetting a birth control pill happens to almost everyone at some point. It can feel stressful in the moment, especially if you had sex recently or are about to. Knowing exactly what to do ahead of time can help you stay calm and protect yourself from an unplanned pregnancy.
This guide walks you through what you should do when you forget your birth control pills, step by step, for both combination pills and progestin-only mini pills. It is meant for general guidance, not as a substitute for advice from your own healthcare provider.
Start with two quick questions
Before anything else, ask yourself:
What kind of pill are you taking?
- Combination pill (contains estrogen and progestin)
- Progestin-only pill, also called the mini pill
How late are you?
- Less than 24 hours since your usual time
- 24 to 48 hours
- More than 48 hours since your last hormone pill
The specific steps you take depend on your pill type and how much time has passed.
If you take combination birth control pills
Combination pills contain both estrogen and progestin. Brand names vary, but if your pack has a week of placebo or sugar pills, you are likely on a combination pill. When you forget these pills, your risk changes based on how many you missed and where you are in the pack.
You are less than 24 hours late or missed one pill
If you are under 24 hours late or realize you forgot a single active pill:
- Take the missed pill as soon as you remember
- Take your next pill at the usual time, even if that means two pills in one day
Missing one combination pill and catching up within 24 hours usually does not significantly raise your chance of pregnancy, especially if you have been otherwise consistent (WebMD, Cleveland Clinic). You typically do not need emergency contraception for just one missed pill in a cycle.
Using condoms or another backup method for the next 7 days is a cautious extra step, especially if you often miss pills or you feel anxious about risk (WebMD, Hey Jane).
You missed one pill by more than 24 hours
If more than 24 hours have passed since you should have taken one active pill:
- Take the missed pill as soon as you remember
- Take the next pill at the usual time
- Use condoms or another backup method for the next 7 days if you want extra protection, especially if you had sex recently (WebMD, Verywell Health)
Most guidelines still treat this like a single missed pill, which has a relatively low risk if you resume correctly. The key is to get back to one pill every day as quickly as possible.
You missed two combination pills in a row
Missing two hormone pills in a row increases your chance of ovulation and pregnancy, especially if it happened in the first week of your pack.
General recommendations are:
- Take the most recent missed pill as soon as you remember
- Throw away any other earlier missed pills
- Take the rest of the pack as usual
- Use backup contraception, like condoms, until you have taken 7 days of hormone pills in a row again (WebMD, Cleveland Clinic, Hey Jane)
If you had unprotected sex during the previous 5 days, talk to your provider or pharmacist about emergency contraception. It can help lower your risk of pregnancy in this situation (Cleveland Clinic, Verywell Health).
You missed three or more combination pills
If you miss three or more hormone pills, your pill pack is no longer reliably protecting you from pregnancy.
Steps to take:
- Start taking hormone pills again right away
- Either
- start a new pack immediately and skip placebo pills, or
- follow your pill’s instructions if they recommend a specific restart plan
- Use backup contraception, such as condoms, for at least 7 days (Cleveland Clinic, Hey Jane)
If you had unprotected sex in the past 5 days, you should strongly consider emergency contraception, since your pregnancy protection is significantly reduced (Cleveland Clinic, Verywell Health).
You forgot placebo or hormone-free pills
The good news is that forgetting placebo pills in your pack does not raise your risk of pregnancy. These pills do not contain hormones.
You can:
- Skip the missed placebo pills
- Start your next pack on time
No backup birth control is needed if you missed only the placebo week (WebMD).
If you take the mini pill (progestin-only)
Progestin-only pills, or mini pills, work on a much tighter schedule than combination pills. With these, timing is critical.
Most mini pills must be taken at the same time every day. If you are more than 3 hours late, it is considered a missed pill and your protection drops (Cleveland Clinic, Hey Jane).
You are less than 3 hours late
If you realize you are late but within a 3 hour window:
- Take the pill as soon as you remember
- Take the next pill at your usual time
Your protection is usually maintained if you stay within this 3 hour window.
You are more than 3 hours late or missed a mini pill
If it has been more than 3 hours since your usual time, or you completely missed a day:
- Take the missed pill as soon as you remember
- Keep taking the rest of the pack at your normal time
- Use backup birth control, like condoms, for at least 2 full days (48 hours) after the missed pill (WebMD, Cleveland Clinic)
This extra protection is important because after a missed mini pill it can take about 2 days for your cervical mucus to thicken again and offer reliable pregnancy protection (Cleveland Clinic).
If you had unprotected sex in the last 5 days while off schedule, talk to your provider or pharmacist about emergency contraception, as your risk of pregnancy is higher with missed mini pills (Verywell Health).
If you miss an entire day’s dose or you are not sure how many pills you missed, contact your healthcare provider for personalized guidance (Verywell Health).
When to consider emergency contraception
Emergency contraception is a backup tool if you had sex when your pill protection was low. This might be the case if:
- You missed 2 or more combination pills and had unprotected sex in the previous 5 days
- You missed 3 or more combination pills anywhere in the pack and had unprotected sex
- You were more than 3 hours late taking a mini pill and had unprotected sex in the last 5 days
- More than 48 hours have passed with no pill and you had unprotected sex (Cleveland Clinic, Verywell Health)
You have a few emergency contraception options:
- A copper IUD, which can be inserted by a provider up to 5 days after unprotected sex and is one of the most effective methods
- Morning after pills, which work best the sooner you take them after sex (Verywell Health)
If you are unsure whether you need emergency contraception, a quick call to your provider, a clinic, or a trusted pharmacy can help you decide.
If more than 48 hours have passed without taking a combination pill and you had unprotected sex within the last five days, your protection is significantly reduced and you should contact your healthcare provider promptly to discuss emergency contraception (Cleveland Clinic).
Spotting and other symptoms after missed pills
When you miss pills and then restart them, you might notice:
- Light spotting or breakthrough bleeding
- A slightly irregular or earlier or later period
- Mild cramps
These changes usually happen because of hormone fluctuations and tend to settle within a few days once you are back on track (Hey Jane). If you have heavy bleeding, bleeding that lasts longer than a week, or strong pain, contact your healthcare provider.
If you frequently forget your pills
If you find yourself often asking what you should do when you forget your birth control pills, it may be a sign that a daily pill is not the best fit for your lifestyle.
You might want to talk with your provider about long acting reversible contraception (LARC). These options include:
- Intrauterine devices (IUDs), hormonal or copper
- Hormonal implants placed under the skin of your arm
These methods do not require daily action, which makes them appealing if remembering pills is challenging (Verywell Health).
Simple habits to help you remember
To lower the chances of forgetting in the future, you can:
- Take your pill at the same time as a daily routine you never skip, like brushing your teeth
- Set a repeating alarm or calendar reminder on your phone
- Keep your pill pack somewhere easy to see, but still private
- Carry a spare pack when you travel or stay overnight elsewhere
Small changes like these can make it easier to stay consistent and reduce the stress of missed doses.
When to call a healthcare provider
Reach out to a provider or clinic if:
- You missed multiple pills and are not sure how to restart
- You think you might be pregnant
- You are having heavy or prolonged bleeding after missed pills (Hey Jane)
- You want to switch to a method that is easier to manage
Having a plan for what to do when you forget your birth control pills can make the situation feel much less overwhelming. Keep your pill instructions handy, save your provider’s number in your phone, and consider writing down your next steps so you are not relying on memory in a stressful moment.
