How to start on extended-cycle birth control pills

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 start: 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

Your extended-cycle tablet dispenser contains three cards of pills. Starting with the first card, 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.

When you finish the first card in your tablet dispenser, take the first pill from the second card the very next day at your normal time. Start the third card the very next day after you finish the second card.

When you have taken the last pill in the tablet dispenser, start taking the first pill from a new extended-cycle tablet dispenser the very next day (this should be the same day of the week that you started your last tablet dispenser) regardless of when your period started.

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. This means you may take 2 pills in 1 day.
• You do not need to use a back-up birth control method if you have sex.

If you miss 2 active pills in a row

• 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.
• You could become pregnant if you have sex in the 7 days after you miss two pills. You MUST use another birth control method (such as condoms) as a backup for the 7 days after you restart your pills.

If you miss 3 or more active pills in a row

• Do not take the missed pills.
• Keep taking 1 pill every day as indicated on the pack until you have completed all of the remaining pills in the pack. For example, if you resume taking the pill on Thursday, take the pill under “Thursday” and do not take the missed pills.
• You may experience bleeding during the week following the missed pills.
• You could become pregnant if you have sex during the days of missed pills or during the first 7 days after restarting your pills.
• You MUST use a non-hormonal birth control method (condoms!) as a backup when you miss pills and for the first 7 days after you restart your pills. If you do not have your period when you are taking the inactive pills, call your healthcare provider because you may be pregnant.

If you miss any of the inactive pills

• Throw away the missed pills.
• Keep taking the scheduled pills until the pack is finished.
• You do not need a backup method of birth control.

Finally, if you are still not sure what to do about the pills you have missed, keep taking one 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.

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