If you are late or miss a pill, just take it as soon as you remember and then continue as recommended
Whether you’re new to PrEP (pre-exposure prophylaxis) or a long-time user, missing a dose can feel like a panic moment. But don’t stress: this is more common than you think, and there are smart, science-backed ways to get back on track.
Here’s everything you need to know if you forget a pill, straight from the experts – no judgment, no fear, just facts.
First: Don’t panic
PrEP (most commonly Truvada or Descovy) is incredibly effective when taken consistently, but the occasional missed dose doesn’t mean you’ve lost all protection – especially if you’ve been taking it as prescribed up to that point. Studies show that daily PrEP still offers strong protection even if you miss a dose once in a while. That said, timing matters.
If you miss one dose
Take it as soon as you remember. If it’s been less than 24 hours, just take the missed dose right away – even if that means taking one pill just a few hours before your next scheduled dose. But if it’s already time for your next pill? Skip the missed one and resume your normal schedule. Do not take two pills at once unless your healthcare provider advises you to.
If you miss two or more doses
Now’s the time to get strategic, because your protection may start to dip, especially if you’re just starting PrEP or have recently resumed taking it. The US Centers for Disease Control (CDC) suggests it takes about seven days of daily use for maximum protection during anal sex (and about 21 days for vaginal sex). So if you’ve skipped more than two doses in a week, especially during a high-risk period, you might want to:
- Avoid sex or use condoms until you’re back on track
- Talk to your healthcare provider about whether post-exposure prophylaxis (PEP) is a better move if you had condom-less sex and believe you may have been exposed
Recommit to your schedule, using tools like reminders or a pill organizer to keep things consistent.
What if you’re on “On-Demand” PrEP?
Some people take PrEP using the 2-1-1 method (common in Europe): two pills taken between two and 24 hours before sex, one pill 24 hours after the first dose, and another 24 hours after that. If you forget one of the post-sex doses, take it as soon as you remember. Be aware that if it’s been more than 12 hours, the dose may not be effective – so be extra cautious moving forward, and consult your healthcare provider.
The real talk: Adherence is key
PrEP only works if you take it. And while missing one dose occasionally is okay, if your forgetfulness is a habit, that can reduce PrEP’s effectiveness – especially for people with vaginas, where drug levels build up differently.
Here are a few simple tips for better adherence:
- Set a daily alarm or calendar reminder.
- Keep your pills next to your toothbrush or connect it to some other daily habit.
- Use an app like Medisafe or My PrEP to track doses.
- Carry a backup dose in your bag or wallet for on-the-go emergencies.
When to call your doctor
If you’ve missed multiple doses or feel unsure about your protection status, it’s completely okay to check in with your provider, who can:
- Advise you on whether PEP is necessary
- Help you restart PrEP correctly
- Offer alternatives that fit your lifestyle (including long-acting injectable PrEP)
No shame, just prevention
Everyone forgets things: this isn’t about failure; it’s about finding a system that works for you. PrEP is one of the most empowering tools in modern sexual health, and learning how to navigate it confidently is just part of the journey.
Missed a dose? You’ve got options, support and science on your side. Keep going.
For tailored advice and up-to-date guidelines, always consult your healthcare provider.
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