Recommended Actions After Late or Missed Combined Oral Contraceptives

If one hormonal If one hormonal pill has been If two or more consecutive hormonal
pill is late: (<24 hours since missed: (24 to <48 hours since pills have been missed: (≥48 hours
a pill should have been taken) a pill should have been taken) since a pill should have been taken)

• Take the late or missed pill • Take the most recent missed pill as soon as possible
as soon as possible. (any other missed pills should be discarded).
• Continue taking the remaining • Continue taking the remaining pills at the usual time
pills at the usual time (even (even if it means taking two pills on the same day).
if it means taking two pills • Use back-up contraception (e.g., condoms) or avoid
on the same day). sexual intercourse until hormonal pills have been taken
• No additional contraceptive for 7 consecutive days.
protection is needed. • If pills were missed in the last week of hormonal pills
• Emergency contraception (e.g., days 15-21 for 28-day pill packs):
is not usually needed but -- Omit the hormone-free interval by finishing the
can be considered (with the hormonal pills in the current pack and starting a new
exception of UPA) if hormonal pack the next day.
pills were missed earlier in the
cycle or in the last week of the -- If unable to start a new pack immediately, use back-up
previous cycle. contraception (e.g., condoms) or avoid sexual
intercourse until hormonal pills from a new pack have
been taken for 7 consecutive days.
• Emergency contraception should be considered
SUN MON TUES WED THUR FRI SAT (with the exception of UPA) if hormonal pills were
1
missed during the first week and unprotected sexual
intercourse occurred in the previous 5 days.
2
• Emergency contraception may also be considered (with
3 the exception of UPA) at other times as appropriate.
4

Abbreviation: UPA = ulipristal acetate

Source: For full recommendations and updates, see the U.S. Selected Practice Recommendations for Contraceptive Use
webpage at http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usspr.htm
 Recommended Actions After Delayed Application
or Detachment* With Combined Hormonal Patch
Delayed application
or detachment for <48
hours since a patch
should have been
applied or reattached
• Apply a new patch
as soon as possible.
(If detachment occurred
<24 hours since the
patch was applied,
try to reapply the patch
or replace with
a new patch.)
• Keep the same patch
change day.
• No additional
contraceptive
protection is needed.
• Emergency
contraception is not
usually needed but can
be considered (with the
exception of UPA)
if delayed application
or detachment occurred
earlier in the cycle
or in the last week
of the previous cycle.
*If detachment takes place but
the woman is unsure when
detachment occurred, consider
the patch to have been detached
for ≥48 hours since a patch should
have been applied or reattached.
Abbreviation: UPA = ulipristal acetate
Source: For full recommendations and updates, see the U.S. Selected Practice Recommendations for Contraceptive Use webpage at http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usspr.htm.
Recommended Actions After Delayed Insertion
or Reinsertion* With Combined Vaginal Ring
Delayed application Delayed insertion of a new Delayed insertion
or detachment for ≥48 ring or delayed reinsertion of a new ring or delayed
hours since a patch should of a current ring for <48 reinsertion for ≥48 hours
have been applied hours since a ring should since a ring should have
or reattached have been inserted been inserted
• Apply a new patch as soon as possible. • Insert ring as • Insert ring as soon as possible.
• Keep the same patch change day. soon as possible. • Keep the ring in until the scheduled ring
• Use back-up contraception • Keep the ring in until removal day.
(e.g., condoms) or avoid sexual the scheduled ring
• Use back-up contraception
intercourse until a patch has been removal day. (e.g., condoms) or avoid sexual
worn for 7 consecutive days.
• No additional intercourse until a ring has been worn
• If the delayed application or detachment contraceptive for 7 consecutive days.
occurred in the third patch week: protection is needed. • If the ring removal occurred in the third
-- Omit the hormone-free week
• Emergency week of ring use:
by finishing the third week of patch use contraception is not -- Omit the hormone-free week
(keeping the same patch change day) usually needed but
by finishing the third week of ring use
and starting a new patch immediately. can be considered and starting a new ring immediately.
-- If unable to start a new patch (with the exception
immediately, use back-up of UPA) if delayed -- If unable to start a new ring
contraception (e.g., condoms) insertion or reinsertion immediately, use back-up
or avoid sexual intercourse until occurred earlier in contraception (e.g., condoms) or avoid
a new patch has been worn for the cycle or in the last sexual intercourse until a new ring has
7 consecutive days. week of the previous been worn for 7 consecutive days.
• Emergency contraception should cycle. • Emergency contraception should
be considered (with the exception be considered (with the exception
of UPA) if the delayed application of UPA) if the delayed insertion
or detachment occurred within the first or reinsertion occurred within the first
week of patch use and unprotected week of ring use and unprotected
sexual intercourse occurred in the sexual intercourse occurred in the
previous 5 days. *If removal takes place but the previous 5 days.
• Emergency contraception may also woman is unsure of how long the • Emergency contraception may also
ring has been removed, consider
be considered (with the exception the ring to have been removed for
be considered (with the exception
of UPA) at other times as appropriate. ≥48 hours since a ring should of UPA) at other times as appropriate.
have been inserted or reinserted.
CS266008-A