Pills out of order

August 6, 2007 6:08 PM

I screwed up my birth control.

First of all, my doctor is STILL on maternity leave so I can't get ahold of her. Second of all, Kaiser Permanente has had me on hold all day and have been passing me around from one advice nurse to another. Thirdly, I know, you are not a doctor, you are not my doctor.

I am taking Tri-Sprintec, the generic Ortho Tri-Cyclen.

On my new pack, I took Day 1 of Week 1. Somehow, the next night I took Day 1 of Week 2. I finished Week 2 before realizing that I skipped Week 1. Last night I figured it out when I got to the Week 3 row. I went ahead and took Day 1 of Week 3. For those of you wondering how I could do something so dumb - I take my pill in the dark. I was also a bad girl 5 days ago, so that adds in some more risk.

What I want to know is if anyone else has done this before, what I should do to try to regulate my cycle, my pregnancy risk, or who I can call to figure this out.
(I didn't want to wait 24-48 hours for the anonymous post)

posted by idiotfactory to health & fitness (11 comments total)

i think the standard advice when you goof (and we all have done it, so don't beat yourself up) is to go ahead and stop taking the pills, let your period come, and start a new pack next sunday (or whatever day you start).
posted by thinkingwoman at 6:22 PM on August 6, 2007

The Planned Parenthood hotline can answer questions like this: I had a similar pill question once when I couldn't call my doctor and I called them instead. It's 1-800-230-PLAN.

I think you should ask them or another doctor about emergency contraception as soon as possible. The PP site says "swallow the pills in the first dose as soon as possible, up to 120 hours — five days — after having unprotected sex." So since it's been five days, I would go find out right now if you should get EC.
posted by lemuria at 6:23 PM on August 6, 2007

I am not a doctor, but I'm pretty sure the best way to get back on track is to just throw out the pack you are currently on. Begin a new pack on Day 1/Week 1 (fresh start). Since Tri-Sprintec is a generic version of Ortho Tri-Cyclen, you'll have to wait a full week before you're protected again. So, don't have sex for a week. Then you should be ok.

You may experience some spotting, and it might take a couple cycles for your period to get back on track, but starting a new pack is usually the safest way to (re) regulate your cycle, make sure you don't ovulate, and eliminate your pregnancy risk.
posted by raztaj at 6:25 PM on August 6, 2007

2nd the 'standard advice,' (and the 'don't beat yourself up, etc') but -- hope this isn't too obvious? -- call a pharmacist.
posted by kmennie at 6:32 PM on August 6, 2007

Seconding the Planned Parenthood hotline -- I called them a few years ago under similar circumstances and they were very helpful. But I agree with lemuria that for your own peace of mind, you should probably just move forward with getting emergency contraception as quickly as possible at this point.
posted by scody at 6:34 PM on August 6, 2007

Of course this is speculation based only on personal experience with Ortho Tri-cyclen. And you should check with a pro to make sure.

I thought that the weeks had increasing amounts of hormone in them. So if you took Weeks 2 and 3 instead of week 1, you ended up getting MORE hormone. It's when you take week 4, the placebo, that you are taking nothing. I would expect that you were protected the whole time.

I'm not sure of the reason for different amounts of hormone, but I know the old pills had tons of hormone in them, so I don't think you're less protected by accidentally taking a higher dose.

To get back on track, I think I'd just start fresh with Week 1 on a new pack--skip week 4--and wait a little longer for your period. My Dr. told me to do this when I had my period scheduled for my wedding day. I just went straight to Week 1 on the new pack after Week 3 on the old one. Never had a period, but I did feel weird and off-cycle for a couple months. Just strange timing, nothing severe, could have been the marriage thing...

So, unless I'm misunderstanding your pills or what you wrote, I think you were protected the whole time.
posted by aimless at 6:39 PM on August 6, 2007

Ortho's Customer Communications Center can be reached by phone at 1-800-526-7736, 9:00 am - 5:00 pm (EST), Monday through Friday.
posted by BrotherCaine at 6:39 PM on August 6, 2007 [1 favorite]

Get other better advice from suggestions above. Failing that, I'd go with aimless' strategy: start new pack immediately. When I was on these evil chemicals, I used to do the back to back thing when I was going on vacation etc. to avoid having a period (at Dr.'s advice).
posted by kch at 9:09 PM on August 6, 2007

To piggy back on what aimless said:

Each white tablet contains 0.180 mg of the progestational compound, norgestimate [...] and 0.035 mg of the estrogenic compound, ethinyl estradiol [...]
Each light blue tablet contains 0.215 mg of the progestational compound norgestimate [...] and 0.035 mg of the estrogenic
compound ethinyl estradiol [...]
Each blue tablet contains 0.250 mg of the progestational compound norgestimate [...] and 0.035 mg of the estrogenic compound ethinyl estradiol [...]

From the PDF here. I'm moderately sure that they're listing them in order, but to double check (and make sure the generic colours match up) you should check the sheet that came with your pills. Anyway, since the dosage was higher then normal, you should have no [more then normal while on the pill] risk of getting pregnant. And since the dosage in general is fairly low (compare here), the health risk is [same as risks for being on the pill normally] very small. I, personally, would continue with week three, and at the end of week three skip the placebo and move on to week one of the next pack (in order to minimize pregnancy risks)... Or continue with week three, and call your doctor when they're available.
posted by anaelith at 10:28 PM on August 6, 2007

I finally got ahold of an advice nurse, seems a bit easier to do after hours. (Planned Parenthood was closed and had me on a wild telephone goose chase)

Since week 2 and week 1 are similar, she said I should take the Week 1 pills now. When that is done, move on to week 3. She also said that week 3 is the riskiest time to mess up, so I'm going to be alright. I just have to use a back-up method -just in case-.

Calling Ortho is a good idea too, I think I will call them tomorrow just to double check.

*phew*
posted by idiotfactory at 11:08 PM on August 6, 2007

If you skip the placebo week, you've got a slightly higher chance of breakthrough bleeding (spotting). Which is also what you had from getting the higher dosage ahead of time. The odds that you somehow ovulated, ahead of time and despite the hormones, are just as low as ever.

But please let me say two things. You probably understand both of them already, but I'll put them on record for future searchers:

1. Make every effort to understand your own medical treatment. That goes double for an ongoing treatment like the pill. (Literally, double: Study it to the limits of your understanding. Then experience it for a while. Then study it again.) After all, this is your body, not your doctor's, and as you now know, it's not enough that your doctor knows what's happening to it. To get you started, here's our own Steven C. Den Beste on birth control.
2. Don't take drugs in the dark. A smart person would figure this out on their own. I had to be told. You had to experience harmless failure. Too many people learn it in more painful ways than these.

On preview, yay for getting through to a real authority!
posted by eritain at 12:01 AM on August 7, 2007