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If a Patient Misses a Pill

It’s important for patients on LYBREL® to take their pill at the same time every day.1 To help them remember, try having them link “pill time” to another daily activity, like brushing their teeth. This way, taking their pill can become second nature.

If a patient misses 1 pill:1

  • She should take the missed pill as soon as she remembers.
  • THEN, she should take the next pill at her regular time. This means she may take 2 pills in 1 day.
  • The patient COULD BECOME PREGNANT if she has sex during the 7 days after she restarts her pills. She MUST use a nonhormonal birth control method (such as condoms and/or spermicide) as a backup for those 7 days.

If a patient misses 2 pills and remembers on the day of the second missed pill:1

  • She should take 2 missed pills on the day she remembers. The following day she is back on schedule to take 1 pill a day.

    For example, a patient takes her pills in the morning and she missed 1 pill on Monday and 1 on Tuesday. On Tuesday evening she remembered that she missed her Monday and Tuesday pills. She takes the 2 missed pills on Tuesday evening, and on Wednesday morning she’s back on schedule and she takes 1 pill.
  • The patient COULD BECOME PREGNANT if she has sex during the 7 days after she restarts her pills. She MUST use a nonhormonal birth control method (such as condoms and/or spermicide) as a backup for those 7 days.

If a patient misses 2 pills and remembers on the day after the second pill is missed:1

  • She takes 2 missed pills on the day she remembers. The next day she takes 2 pills. The following day she is back on schedule to take her pills.

    For example, a patient takes her pills in the morning and she missed 1 pill on Monday and 1 pill on Tuesday. On Wednesday morning she remembers that she missed her Monday and Tuesday pills. She takes the 2 missed pills on Wednesday morning and 2 pills on Thursday morning. On Friday morning she’s back on schedule and she takes 1 pill.
  • The patient COULD BECOME PREGNANT if she has sex during the 7 days after she restarts her pills. She MUST use a nonhormonal birth control method (such as condoms and/or spermicide) as a backup for those 7 days.

If a patient misses 3 or more pills:1

  • She should contact her health care professional for further advice. The patient should keep taking one pill every day until she reaches her health care professional. She should not take the missed pills.
  • The patient COULD BECOME PREGNANT if she has sex during the 7 days after she restarts her pills. She MUST use a nonhormonal birth control method (such as condoms and/or spermicide) as a backup for those 7 days.
Next: Helping Patients Remember to Take Their Pills »

Important Safety Information

  • Oral contraceptives (OCs) do not protect against HIV infection or other sexually transmitted diseases.
  • When prescribing LYBREL, the convenience of having no scheduled menstrual bleeding should be weighed against the inconvenience of unscheduled breakthrough bleeding and spotting.
  • OCs are contraindicated in women who have blood clots; breast, uterine, or liver cancers; a history of heart attack, stroke, or breast cancer; as well as those who are or may be pregnant.
The risks of serious cardiovascular side effects are substantially increased in women who smoke and use OCs, especially in women over age 35. Women who use oral contraceptives should be strongly advised not to smoke.
  • Serious risks associated with OCs include blood clots, heart attack, and stroke.
  • LYBREL provides women with more hormonal exposure on a yearly basis (13 additional weeks of hormone intake per year) than conventional cyclic oral contraceptives containing the same strength of synthetic estrogens and similar strength of progestins.
  • Scheduled withdrawal bleeding does not occur with the use of LYBREL, therefore, the absence of withdrawal bleeding cannot be used as a sign of an unexpected pregnancy and as such, unexpected pregnancy may be difficult to recognize. Although pregnancy is unlikely if LYBREL is taken as directed, if for any reason, pregnancy is suspected in a woman using LYBREL, a pregnancy test should be performed.
  • The most commonly reported treatment emergent adverse events reported with LYBREL in a clinical trial were headache, dysmenorrhea, upper respiratory infection, vaginal bleeding (defined as metrorrhagia and vaginal hemorrhage), and nausea.

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