How to start the 28 day combined oral contraceptive pill
There is more than one way to start the pill. Use whichever method you prefer.
Quick start: If you are certain you’re not pregnant, take your first COC the day you get your pills. (If you’re not certain, take a pregnancy test before taking the pill.)
- If you start the pill within 5 days after the start of your period, you are protected against pregnancy right away. For example, if you started your period Thursday morning, you have until Tuesday morning to start taking your pill and still be protected from pregnancy right away.
- If you start the pill more than 5 days after your last period started (Tuesday afternoon or later, in our example), then use a backup method (condom!) every time you have sex for the next 7 days to protect against pregnancy. After 7 days, you will be protected from pregnancy on the pill alone.
- Tip: If you start your pill pack on any day other than Sunday, use the weekday stickers provided in your pack to place the appropriate days of the week above the first row of pills.
First day of period: Take your first COC on the first day of your period. No backup method is needed. You are protected against pregnancy right away.
How to take the pill
Take one pill each day, at the same time of day until the pack is empty.
- Tip: Set up a daily alarm on your phone to remind you to take your pill at the same time each day. Or sign up for reminders from Nurx and we will ping you when it’s time to take your next pill.
- Tip: Keep your pills in your wallet so you’ll always have them with you when it’s time to take one.
Start the next pack the day after you finish the last pack. There is no break between packs.
Do not skip pills even if you are experiencing spotting or bleeding or feel sick to your stomach (nausea).
Do not skip pills even if you don’t have sex very often.
What to do for a late or missed pill
If you miss 1 active pill
- Take the missed pill as soon as you remember.
- Take the next pill at your regular time, even if that means you take 2 pills in one day.
If you miss 2 active pills in a row in Week 1 or Week 2 of your pack
- Take 2 pills on the day you remember and 2 pills the next day.
- Then take 1 pill a day until you finish the pack.
If you miss 2 active pills in a row in Week 3 of your pack
- Throw out the rest of the pill pack and start a new pack that same day.
- You may not have your period this month but that is expected.
If you miss 3 or more active pills in a row (during the first 3 weeks)
- Throw out the rest of the pill pack and start a new pack that same day.
You could become pregnant if you have sex in the 7 days after you restart your pills. You must use a backup birth control method (such as condoms) as a backup for those 7 days.
If you had unprotected sex before you were back on the pill for 7 consecutive days, and that’s within the last five days, you might want to take emergency contraception just in case.
If you forget any of the reminder pills in Week 4
- Just throw away the pills you missed.
- Keep taking 1 pill each day until the pack is empty.
- You do not need a backup method if you start your next pack on time.
Finally, if you are still not sure what to do about the pills you have missed, keep taking one active pill each day and use a backup method anytime you have sex until you can talk with a doctor at Nurx or another health care provider.
This blog provides information about telemedicine, health and related subjects. The blog content and any linked materials herein are not intended to be, and should not be construed as a substitute for, medical or healthcare advice, diagnosis or treatment. Any reader or person with a medical concern should consult with an appropriately-licensed physician or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.