Is it bad if you take the pill twice in one day? Here's what you need to know

October 12, 2025 •

5 min read

An estimated 9% of women on oral contraception report missing at least one pill during their cycle. If you find yourself in this situation, you might wonder: is it bad if you take the pill twice in one day? The good news is that for most people, doubling up to catch up on a missed dose or doing so accidentally is generally safe, although it can cause some temporary side effects.

Quick Summary

Doubling up on your oral contraceptive, especially after a missed dose, is generally safe but may cause mild, temporary side effects like nausea or spotting. The correct action to take depends on the type of pill and how many doses were missed, but typically you simply continue your regular schedule.

Key Points

Generally Safe: Taking two birth control pills in one day is typically not dangerous and is a common remedy for a missed dose.
Mild Side Effects: Mild symptoms like nausea, spotting, and headache can occur due to the temporary hormone increase.
Mini-Pill Is Different: If you're on the progestin-only pill (mini-pill), timing is more crucial; you must still use backup contraception for seven days after a missed dose, even if you take two pills.
Continue Your Schedule: After doubling up to catch a missed dose, simply continue taking one pill a day as scheduled. You will finish your pack one day early.
Emergency Care for Severe Symptoms: While rare, seek immediate medical help for severe symptoms like chest pain, trouble breathing, or allergic reactions.
Consult a Doctor for Frequent Misses: If you frequently miss doses, consider speaking with a healthcare provider about a different contraceptive method that requires less daily maintenance.

Understanding Oral Contraceptives and Dosing

Oral contraceptives, commonly known as birth control pills, contain synthetic versions of hormones—estrogen, progestin, or both—that prevent pregnancy. The precise, low dosage of these hormones in each pill is carefully calibrated to keep your hormone levels stable and prevent ovulation. Taking a dose outside of the normal schedule, or an extra dose, disrupts this equilibrium, but the body is very good at processing these hormones, making a single double dose unlikely to cause serious harm.

There are two main types of oral contraceptives, and the reaction to a missed or extra pill depends on which type you're taking. Most common are combined pills, which contain both estrogen and progestin. These typically offer a wider window for error. The second type is the progestin-only pill, often called the mini-pill, which is much more sensitive to timing. A missed dose of the mini-pill, even by just a few hours, can be enough to compromise its effectiveness.

What to do if you take the pill twice

Your response to taking two pills in one day will depend on whether it was intentional (to make up for a missed dose) or accidental, and what type of pill you are on.

If you missed a combined pill

This is the most common reason for taking two pills in one day, and it is standard protocol for maintaining contraceptive protection.

Take the missed pill immediately when you remember, even if that means taking two pills in one day (your missed pill and your regularly scheduled one).
Continue your regular schedule from the next day onward.
You do not need backup contraception if you missed only one active pill.

If you missed two or more combined pills

Take the most recent missed pill as soon as you remember. Discard any other missed pills.
Use backup contraception like condoms for the next seven days.
Refer to the package instructions or consult a healthcare provider for specific guidance, especially if pills were missed in the first week and unprotected sex occurred.

If you missed a progestin-only pill (mini-pill)

Take the missed pill immediately as soon as you remember, which may mean taking two pills in one day.
Use a backup method for the next two to seven days, depending on the specific type of mini-pill you are on and the instructions. The mini-pill has a much narrower window for effectiveness compared to combined pills.

If you accidentally took an extra pill

Don't panic. This is not a medical emergency.
Continue taking your pills at your usual time the next day. You will finish your pack a day early, but your contraceptive protection will not be affected.

Common side effects of doubling up

Because you are introducing a higher concentration of hormones into your system at once, you may experience some temporary, mild side effects. These are typically not serious and resolve within a day or two.

Nausea: A common side effect of a sudden increase in hormone levels. Taking the pill with food can help alleviate this.
Vomiting: In some cases, a higher dose can cause vomiting, which may affect the pill's absorption. If you vomit within a few hours of taking the pills, you may need to take another dose.
Spotting or breakthrough bleeding: Unplanned vaginal bleeding is possible as your body reacts to the extra hormones.
Breast tenderness: Your breasts may feel more sensitive or sore.
Headache: Some people may experience a temporary headache.
Mood changes: Hormonal fluctuations can impact mood, leading to irritability.

When to seek medical attention

While taking two pills in one day is usually not dangerous, certain severe symptoms should prompt immediate medical attention. These symptoms are rare after a minor overdose but are important to be aware of.

Sudden, severe or persistent pain (especially chest pain)
Unusual or severe headache
Trouble breathing or shortness of breath
Swelling or unusual pain in your legs
Signs of a severe allergic reaction, such as facial swelling or hives
Heavy vaginal bleeding (soaking through a pad or tampon in under 2 hours)
Persistent or severe vomiting

Comparison: Accidental double dose vs. larger overdose


Feature	Accidental Double Dose (1 or 2 extra pills)	Large Intentional Overdose (multiple pills)
Scenario	Typically occurs when a pill is missed and remembered the next day.	Involves intentionally taking a large number of pills for reasons other than contraception (e.g., self-harm, emergency contraception).
Contraceptive Effect	Remains effective, provided standard catch-up rules are followed for combined pills.	Does not increase contraceptive effectiveness. Will not terminate an existing pregnancy.
Toxicity	Very low toxicity due to low hormone levels in oral contraceptives.	Still low toxicity, unlikely to be life-threatening.
Common Side Effects	Mild and temporary: nausea, spotting, headache.	More pronounced or persistent side effects: increased nausea, vomiting, significant spotting.
Action Required	Continue regular schedule. Monitor mild symptoms.	Seek medical attention immediately, especially if related to self-harm. Contact Poison Control.
Emergency Potential	Very low.	Elevated risk for severe symptoms, requires medical evaluation.

Long-term considerations for frequent misses

If you find yourself consistently forgetting pills, it may be a sign that your current contraceptive method is not the best fit for your lifestyle. Consider alternatives that don't require a daily memory prompt. Options include a hormonal or non-hormonal IUD, an implant, or contraceptive injection. Consulting with a healthcare provider can help you find a more reliable method that fits your needs and reduces the stress of missed doses.

Conclusion

While taking the pill twice in one day can be a cause for concern, it is generally safe, especially if done to compensate for a single missed dose of a combined pill. Mild side effects like nausea or spotting may occur but are temporary. It is crucial to follow the specific instructions for your type of pill and to seek immediate medical attention if any severe symptoms, such as those related to blood clots, appear. If you frequently forget to take your pill, it may be time to discuss more convenient and reliable options with a healthcare professional to ensure consistent protection. Planned Parenthood's information on missed pills is an excellent resource for further guidance.

Frequently Asked Questions

If you accidentally took two birth control pills in one day, don't worry. This is not dangerous, and you will likely experience no significant side effects. Simply continue your normal schedule by taking one pill the next day. You will finish your pill pack one day early.

Yes, taking two birth control pills in one day can cause mild and temporary side effects, including nausea. This happens because of the sudden, increased dose of hormones. Taking the pills with food can help mitigate this effect.

If you missed one combined pill, take it as soon as you remember. If you remember on the next day, you will take two pills. Continue with your regular pill schedule afterward. You will not lose contraceptive protection.

Taking two pills in one day, either accidentally or to make up for a missed dose, can cause temporary spotting or breakthrough bleeding. It will not have a long-term effect on your period and is not a cause for concern.

True overdose on birth control pills is not life-threatening due to their low toxicity. Taking a large number of pills can lead to pronounced side effects like nausea and vomiting but is unlikely to cause serious harm. Seek medical help if a large number were taken intentionally or if severe symptoms occur.

If you missed only one combined pill and take it as soon as you remember, you do not need backup contraception. If you missed two or more combined pills, or if you missed a progestin-only mini-pill, you should use backup contraception for seven days.

If you miss a progestin-only mini-pill, take it as soon as you remember, even if that means taking two pills in one day. The timing is very important with mini-pills, so you must also use a backup birth control method for the next two to seven days, depending on your pill's specific instructions.

You should call a doctor if you experience severe symptoms, such as persistent vomiting, heavy bleeding, severe abdominal pain, chest pain, or trouble breathing. These could indicate more serious issues, though they are not typically caused by a minor double dose.