Take one pill daily, beginning on the first day of menstrual bleeding. Patient may also start any day as long as patient is not pregnant but use a back-up method such as condom for the next seven days as a precaution to avoid pregnancy. Breastfeeding women can start six weeks after giving birth. Start with the pill marked with the corresponding day of the week. Follow the arrows indicated on the pack.
The interval between two pills should be 24 hours. Incorporate it to patient's daily routine-after evening meals or before going to sleep to easily remember to take it. A pack is good for 28 days.
Start a new pack the next day after taking the last pill.
Patient may continue taking the pill as long as wanted to avoid pregnancy. Do not skip taking the pill even if there is a brief pause from sexual activity.
Patient should only stop taking the pill after finishing a pack; otherwise bleeding may start.
Vomiting and persistent severe diarrhea can interfere with the absorption of the pill. If vomiting occurs within two hours of taking pill, another pill should be taken as soon as possible. If the replacement pill is not taken within 3 hours of the normal time of taking the pill, or in cases of persistent vomiting or severe diarrhea, a back-up method such as condom should be used during illness and for 2 days after recovery.
If patient missed a pill, it should be taken three hours after the 24-hour lapse to sustain its efficacy. Take the remaining pills as scheduled to avoid premature withdrawal bleeding. Follow the instructions on Missed Pills.
MISSED PILLS: The key to effective contraception is following the recommended dosage consistently.
Regularity in taking the pill is very important because contraceptive efficacy is reduced if a pill is delayed by more than three hours.
If the pill is less than three hours overdue, take it as soon as remembered. Resume taking the next scheduled pill. Patient will not need a back-up contraceptive method.
If the pill is more than three hours overdue, take it as soon as remembered and either abstain from sex or use condoms for the next two days. Resume taking the next scheduled pill. (See figure.)
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If patient continually forgets to take the pills, ask the healthcare provider for ways to become compliant, or for another method of contraception such as an injectable which will suit the patient better.