Shokoufeh asked
I am taking birth control pill at everyday 6 pm. I am traveling to Turkey tomorrow. Due to different time zone I’d have to take the pill at 4:15 am which is too early. How can I change the schedule without changing the effectiveness? I’ve read somewhere to take the pill twice on one day and continue with the new schedule on the following days. For example, take it at 4:15 am and 10 pm and continue to take it at 10 pm the following days. Is that the best option?
Answer
It isn't uncommon for individuals to need to change the time they take their birth control pill. Fortunately, there are clear recommendations on how to do this. Below we discuss how to change the time your birth control pill, either earlier or later in the day.
How To Take Your Birth Control Pills Earlier
Changing the time you take your birth control pill to earlier in the day is easier and simpler than changing to later in the day. To change your birth control dosing time to earlier:
- Take your pill at your new desired time, earlier in the day.
- Since you are taking your pill earlier and will not be late or miss a dose, you do not need to use back-up birth control.
The following is an example scenario of switching your pills to earlier in the day:
- You usually take your pills at 9 PM.
- You now want to take them at 9 AM.
- Take your usual dose at 9 PM and when you want to switch, simply take the next dose at 9 AM.
- Although you will be taking two pills in a 24 hour window, this is safe. You do not need to use back-up contraception.
How To Take Your Birth Control Pills Later
Changing the time you take your birth control pills later in the day is a little more challenging. The easiest (although not always the most feasible) way to do this is as follows:
- Simply change the time you take your pills when you are starting a new pack.
- Since you will not be late or miss a dose, there is no need to use back-up contraception.
If you cannot wait to start a new pack to change your time, it is important to note that anytime you miss doses or are late (which will happen if you miss your usual dose to change to later in the day), the efficacy of your birth control may be reduced. Nevertheless, certain sources, such as this diagram from the CDC (Centers For Disease Control) state that as long as you aren't more than 24 hours late taking your pill, you do not need to use back-up contraception.
Other sources are more conservative however. Some state that if you are more than 12 hours late taking your birth control pill (which could happen if you usually take your pill at 8 AM and wanted to switch to 10 PM), you should use back-up contraception for at least 7 days.
If you are taking a progestin only pill (i.e. POP or "mini-pill), there is even less leeway. If you are more than 3 hours late in taking your progestin only pill, that is considered a missed dose and you should use back-up birth control for at least 7 days.
Another option is to take two pills in one day, but this means you will be altering your schedule by one day, and finishing one day sooner. As long as the day you finish (and then therefore the day you start your new pack) doesn't matter to you, this may be an option. In your situation, you want to switch to later in the day (more than 12 hours later, from 4:15 AM to 10 PM). You can:
- Take your usual dose at 4:15 AM
- Take your next dose at 10 PM
This means taking two doses in 24 hours (and on the same physical day) which will cause you to have one less pill in your pack and therefore, finish one day sooner. This is a fine and safe method as long as you are okay with that. You may experience slight nausea from the extra dose of hormones, but generally is mild.
If you just want to switch from 4:15 AM to 10 PM without taking two pills in one day, that is fine but just to be safe, use back-up contraception (e.g. condoms) for a least 7 days if you are sexually active.
