What should be done if a dose of the progesterone-only pill (POP) is missed and not taken until 9:40pm, having previously taken it at 6pm every day?

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From the Guidelines

If you forget to take your progesterone-only pill at 6 pm and realize it's 9:40 pm, you should take the missed pill as soon as possible and continue taking pills daily at the same time. According to the U.S. selected practice recommendations for contraceptive use, 2013, a dose is considered missed if it has been >3 hours since it should have been taken 1. In this scenario, being 3 hours and 40 minutes late is considered a missed dose. The recommendations suggest taking one pill as soon as possible, continuing to take pills daily at the same time, and using backup contraception or avoiding sexual intercourse until pills have been taken correctly for 2 consecutive days 1. Key points to consider include:

  • Take the missed pill as soon as possible
  • Continue taking pills daily at the same time
  • Use backup contraception, such as condoms, for the next 48 hours
  • Emergency contraception should be considered if unprotected sexual intercourse has occurred It's essential to maintain consistent timing when taking the progesterone-only pill to ensure its effectiveness in preventing pregnancy, as it works by thickening cervical mucus and thinning the uterine lining 1.

From the Research

Missing a Progesterone Only Pill

If you take the progesterone only pill at 6pm every day and forget to take it one day, realizing it's 9:40pm, here are some key points to consider:

  • The progesterone only pill is most effective when taken at the same time every day [(2,3)].
  • If you miss a pill, it's essential to take it as soon as possible [(4,5)].
  • Since you forgot to take your pill at 6pm and it's now 9:40pm, you should take the missed pill immediately [(4,5)].
  • You should also take your next pill at the usual time, which would be 6pm the following day [(4,5)].

Emergency Contraception

If you have had unprotected sex or a contraceptive accident, you may need to consider emergency contraception:

  • Emergency contraception is available in various forms, including oral pills and intrauterine devices (IUDs) [(2,3,6)].
  • The progesterone only pill, also known as levonorgestrel (LNG), is a common form of emergency contraception [(4,5)].
  • LNG is most effective when taken within 72 hours of unprotected sex, but it can be taken up to 5 days after [(5,6)].

Important Considerations

When using the progesterone only pill or emergency contraception:

  • It's crucial to follow the instructions carefully and take the pills at the correct time [(4,5)].
  • You should also be aware of any potential side effects or interactions with other medications [(4,5,6)].
  • If you have any concerns or questions, you should consult a healthcare professional for guidance [(2,3,6)].

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Practice Bulletin No. 152: Emergency Contraception.

Obstetrics and gynecology, 2015

Research

Emergency contraception.

Archives of family medicine, 2000

Research

Emergency contraception.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2013

Research

Emergency contraception: which is the best?

Minerva ginecologica, 2016

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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