Missed pills
What if I vomit after taking my pill?
Quick answer
If you vomit within 2 hours of a hormone pill, WHO says to take another hormone pill from your pack as soon as you can.[src] Vomit later than that, and the pill has been absorbed, so carry on as normal. If vomiting or severe diarrhoea lasts more than 2 days, follow the missed pill rules for each day you were sick.
The 2-hour rule
A pill needs time in your stomach and gut to be absorbed. WHO's handbook uses 2 hours as the cut-off.[src]
- Vomited within 2 hours: treat that pill as not taken. Take another hormone pill as soon as you can keep it down.
- Vomited after 2 hours: the pill counts. Nothing extra to do. Take your next pill at the usual time.
- Not sure when? If you cannot tell, it is simpler to treat it as within 2 hours and take another pill.
This applies to combined pills like Trust (levonorgestrel + ethinylestradiol) and Yaz (drospirenone + ethinylestradiol), and to progestin-only pills like Daphne (lynestrenol). On a progestin-only pill, the 3-hour window (12 hours for Cerazette (desogestrel)) still applies to the replacement, so do not wait until tomorrow.[src]
Which pill to take
If you have a spare pack, take a hormone tablet from it, so your main strip stays in step with the days. If you do not, take the next hormone tablet in your strip and carry on in order. Your strip then ends one day early, so you start your next pack one day early too. That is fine. On Trust, the brown tablets are iron, so vomiting after a brown tablet changes nothing.[src]
If you vomit the replacement pill too within 2 hours, wait until you are keeping fluids down, then try again. If you cannot keep anything down, you are moving into the next situation.
Sick for more than 2 days
WHO says that if severe vomiting or diarrhoea lasts more than 2 days, follow the missed pill steps, counting each sick day as a missed pill.[src] In practice:
- Keep taking a pill each day if you can.
- Once you are better, count how many days were affected and use the Missed Pill Helper with that number. On a 30 to 35 mcg pill, 3 or more days means condoms for 7 days. On a 20 mcg pill, 2 or more days does.[src]
- If you had sex during or just before the illness, talk to a doctor today about emergency options.
Severe or bloody diarrhoea, signs of dehydration or vomiting that will not stop need medical care in their own right. Go to a clinic or ER, and mention you are on the pill.
Common Filipino scenarios
- Nausea from the pill itself in the first months: take it at night or with food. It usually settles.[src]
- Food poisoning or a stomach bug after a fiesta or a trip: apply the 2-hour rule, then the 2-day rule.
- Vomiting after a night of drinking: same rules. See can I drink alcohol on the pill?
- Motion sickness on a long bus or boat trip: take your pill well before or well after the trip.
If unsure, talk to a doctor or pharmacist.
Frequently asked questions
Nagsuka ako pagkatapos uminom ng pills, ano gagawin?
Kung nagsuka ka sa loob ng 2 oras pagkainom, uminom ng isa pang hormone pill mula sa pack mo. Kung lampas 2 oras, tuloy lang. Kung lampas 2 araw ang pagsusuka o pagtatae, sundin ang missed pill rules.
Does diarrhoea stop the pill working?
Mild diarrhoea usually does not. WHO says severe diarrhoea lasting more than 2 days should be treated like missed pills for each day you were sick.
Should I take two pills the next day instead?
No need to double up later. Take the replacement as soon as you can keep it down, then carry on with one pill a day.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Managing missed pills (Family Planning Handbook), WHO and Johns Hopkins CCP
- Trust pill listing: Prescription Required, Watsons PH
- Combined pill: risks and side effects, NHS