What are the effects of taking two desogestrel (progestin) pills by accident?

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Last updated: May 31, 2025View editorial policy

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From the Guidelines

Taking two desogestrel pills by accident is not a cause for serious concern, and you should continue taking your pills as scheduled without skipping any doses or taking extra pills to compensate. According to the U.S. selected practice recommendations for contraceptive use, 2013, if a dose is missed, it is recommended to take one pill as soon as possible and continue taking pills daily, one each day, at the same time each day, even if it means taking two pills on the same day 1. You might experience temporary side effects such as nausea, headache, breast tenderness, spotting, or breakthrough bleeding. These symptoms typically resolve on their own within a day or two. Desogestrel is a progestin-only contraceptive that works primarily by thickening cervical mucus and thinning the uterine lining, with a relatively narrow therapeutic window.

Some key points to consider:

  • Peak serum steroid levels are reached about 2 hours after administration, followed by rapid distribution and elimination, such that by 24 hours after administration, serum steroid levels are near baseline 1.
  • Taking POPs at approximately the same time each day is important to maintain contraceptive effectiveness.
  • An estimated 48 hours of POP use was deemed necessary to achieve the contraceptive effects on cervical mucus 1.
  • If you're concerned about contraceptive effectiveness, consider using a backup method for the next 48 hours, especially if the doubled dose was taken at the beginning or end of your pill pack.
  • Persistent symptoms like severe abdominal pain, chest pain, severe headache, eye problems, or shortness of breath warrant medical attention.

From the Research

Effects of Taking Two Desogestrel Pills by Accident

  • There is no direct evidence in the provided studies that specifically addresses the effects of taking two desogestrel pills by accident.
  • However, the studies suggest that desogestrel is generally well tolerated as a contraceptive and in hormone replacement therapy, but its use is associated with a doubled risk of venous thromboembolism compared to second-generation progestins 2.
  • Desogestrel has been shown to improve estrogen-related symptoms and dysmenorrhea in women, with most women experiencing resolution or improvement of symptoms 3, 4.
  • The most common adverse events reported with desogestrel use are bleeding irregularities, which may include increased frequency of bleeding, lengthened cycles, breakthrough bleeding, spotting, and prolonged bleeding 3, 5.
  • It is likely that taking two desogestrel pills by accident may increase the risk of bleeding irregularities and other adverse events, but the exact effects are not specified in the provided studies 2, 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Drug safety evaluation of desogestrel.

Expert opinion on drug safety, 2013

Research

The effects of an oestrogen-free, desogestrel-containing oral contraceptive in women with cyclical symptoms: results from two studies on oestrogen-related symptoms and dysmenorrhoea.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2007

Research

The progestin-only pills drospirenone 4 mg and desogestrel 0.075 mg as an option for the management of dysmenorrhea and mastodynia.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 2022

Research

Progestogen-only pills and bleeding disturbances.

Human reproduction (Oxford, England), 1996

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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