Contraceptive methodDuration since last dose or useRecommendationTransition to next cycleBackup methodEmergency method
Combined oral contraceptives< 48 hours and only one missed pillTake the missed pill as soon as possible; this is not needed in cases of vomiting or diarrheaTake the remaining pills at the usual time each day (this may require taking two pills on the first day)NoneNot usually needed*
≥ 48 hours and two or more missed pills

  • Take the most recent missed pill as soon as possible

  • In cases of vomiting or severe diarrhea, take the next pill as soon as tolerated

  • Other missed pills should be discarded

Take the remaining pills at the usual time each day (this may require taking two pills on the first day)†7 consecutive days (without vomiting or severe diarrhea)If appropriate‡
Progestin-only pill> 3 hours past recommended dose (i.e., > 27 total hours since previous dose), or vomiting or diarrhea within 3 hours of doseTake one pill as soon as possibleTake the remaining pills at the usual time each day (this may require taking two pills on the first day)2 consecutive days (without vomiting or severe diarrhea)Consider if recent unprotected intercourse
Combined hormonal patch (delayed application or detachment)< 48 hoursApply a new patch as soon as possibleKeep the same patch-change dayNoneNot usually needed*
≥ 48 hoursApply a new patch as soon as possibleKeep the same patch-change day†7 consecutive daysIf appropriate‡
Combined vaginal ring (delayed insertion of a new ring or reinsertion of a current ring)< 48 hoursInsert ring as soon as possibleKeep the ring in until scheduled removal dayNoneNot usually needed*
≥ 48 hoursInsert ring as soon as possibleKeep the ring in until scheduled removal day†7 consecutive daysIf appropriate‡
Injectables (i.e., depot medroxy-progesteroneacetate [Depo-Provera])< 2 weeks late (< 15 weeks after previous injection)Proceed with injectionNot applicableNoneNone
≥ 2 weeks lateTreat as new startNot applicable7 consecutive daysConsider use