How to take the pill:
During the first 7 days of the first package of pills you are not protected from pregnancy and need to abstain or use back up birth control method (i.e. condoms).
Begin taking the pill either on the Sunday after your period begins or on the first day of your next period.
Try to take your pill at the same time each day, ideally within 2 hours of the same time each day. In the evening following a meal may be a better time of day to reduce the chance for nausea.
If you miss a pill:
- If you miss 1 pill, take it as soon as you remember. If you don't remember until the next day, you will be taking 2 pills the next day and may become nauseated. You may have spotting within 10 days.
- If you miss 2 pills in a row (first two weeks), take 2 pills for 2 days and also use a back-up birth control method for the next 7 days.
- If you miss 2 or more pills in a row (third week), or you miss 3 or more pills in a row any time:
- If you always start on Sundays, keep taking pills until the next Sunday. Start a new pack that Sunday. Also use a back-up birth control method for the next 7 days.
- If you do not start on Sundays, throw out the rest of the pill pack. Start the next pack that day. Also, use a back-up birth control method for the next 7 days.
- If you miss either the first 2 or last 2 medicated pills in the cycle package, use a back-up birth control method for at least 7 days (i.e. condoms) because there is greater risk for pregnancy in this situation.
- For those on 28-day packs: If you forget any of the 7 green "reminder" pills in Week 4, throw away the pills you missed. Keep taking 1 pill each day until the pack is empty. You do not need a back-up method of birth control.
- If you are still not sure what to do about the pills you have missed, use a back-up method of birth control anytime you have sex. Keep taking one active pill each day until you can contact your health care provider at the Student Health Center by calling (757) 221-4386.
Antibiotics and oral contraceptives:
Much controversy exists on whether antibiotics inactivate combined oral contraceptives. New research indicates the risk is very low to nonexistent unless the antibiotic is rifampin or griseofulvin. However, you may want to consider a backup method for the duration of the antibiotic plus 7 days, especially if abdominal cramps, vomiting, diarrhea, or breakthrough bleeding develop while on the antibiotic. Note that other antibiotics such as those in the penicillin and tetracycline classes also carry a risk of making your birth control pill less effective, although the risk is much less than with rifampin and a backup method of birth control is typically not recommended. For long term antibiotics, a backup method of birth control may be advisable for at least 2 weeks...until the GI flora become resistant and less likely to affect estrogen absorption.
Other medications and oral contraceptives:
other medications that can compromise efficacy include drugs for seizure disorders: Phenytoin, Carbamazepine, Phenobarbital, Primidone, Felbamate, Topiramate, Vigabatrin. The only over the counter supplement known to decrease oral contraceptive effectiveness is St. John's Wort.
Prescription refills and blood pressure:
If you are just starting birth control pills, remember to return to the SHC in 3 months for a blood pressure check - an appointment is not necessary for this. A prescription refill will be given at that time if appropriate. If you have concerns about your prescription before that time, call the Student Health Center at (757) 221-4386.