Hi XXXXXXX

Thanks for writing in.

I would like to advise you that if you trust this medicine for contraception you should be both regular & punctual. If you had accidentally taken two pills on Tuesday, you should not have left the next day without a pill, rather you should have continued with the next pill on the strip on Wednesday. If you are late for more than 12 hours for a pill then the efficacy of birth control may get affected. This has happened in your case as there was a 24 hour gap on Wednesday.

Generally, if you miss a pill you should use extra contraception for next 7 days.

Now coming to your question, in such situations I shall tell you what I tell to my patients:
- please check your pack if there are more than 7 pills remaining after Wednesday continue to take one pill daily and follow the usual routine of break after you have finished the pack. There is not much to worry about.
- If there are less than 7 pills in the pack after the Wednesday, then finish your pack as usual. Don't take a pill free break and start a new pack write away when you finish this pack. In this case you may not have period this month, but after you finish your 2nd pack you should have the period. If not, do a pregnancy test. As the bleeding following the 2nd pack might be heavy, discuss with your prescribing doctor about this.
- If you have missed a pill in the first seven days of the packet & had sex during this week, you may become pregnant. You should consult your health care provider for emergency contraception.

It is a good practice, to use a barrier method of contraception (condom) in addition to the pill as it will protect you from STDs & also provide a back up method in cases like yours.

You are expected to have regular checkups with your prescribing doctor, while you are on this pill including the cervical smear tests.

I think I have answered your question in an acceptable way. Please feel free to contact me for any further question.

Regards

---