What should I do if I miss my dose?

There are occasions when people forget to take their medication at correct prescribed times.  This may have not only have an effect on potentially making the medication less effective but it may also inadvertently lead to taking doses too close together, thereby increasing the risks of side effects.

Here we list the steps you should take:

1. Check the patient information leaflet (UK) or patient package insert (US)

The Patient Leaflet supplied with the medicine is the first place to look for advice if someone forgets to take a dose of their medicine at the usual time.

This will usually contain specific advice for patients about missed or forgotten doses. Alternatively, you can find copies of inserts on:

• UK – the Medicines and Healthcare products Regulatory Agency (MHRA) website
• US – The U.S. Food and Drugs Administration (FDA) website 

2. Check the NHS website (UK)

The NHS website contains a selection of Medicines Guides.

These include advice for patients on missed doses. This is normally phrased as a question: ‘What if I forget to take it?’.

3. Follow this general advice

Only follow this advice if you cannot find a Patient Information Leaflet or insert.

The advice depends on how late the dose is:

If the dose is less than 2 hours late:

Take the missed dose as soon as it is remembered.

As a general rule, for the vast majority of medicines it is acceptable to take a dose up to 2 hours late.

Additional advice:

As a one-off, you can usually disregard any warnings about taking the medicine before or after meals. It is more important to take the dose.

Watch for side effects – taking medicines at shorter intervals than usual may cause more side effects.

If the dose is more than 2 hours late:

The advice depends on how often the person usually takes the medicine:

Once or twice each day

• Take the missed dose as soon as it is remembered as long as the next dose is not due within a few hours.
• Then continue taking the medicine at the usual times.

More often than twice a day

• Skip the missed dose, and wait until the next dose is due.
• Then continue taking the medicine at the usual times.

4. Do not take a double dose

Never take a double dose to make up for a forgotten dose unless specifically advised.

5. Seek further advice

If in doubt, people should seek advice from a pharmacist, doctor or your specialist nurse/clinic.

This is particularly advisable if:

• You have missed more than one day of treatment
• You are taking the medicine less frequently than once a day (e.g. on alternate days, once weekly, monthly) or they are following a less typical dosing regimen
• You are taking certain medicines that need special care or have special instructions such as:

• • Epilepsy Medications
  • Oral Contraceptives
  • Warfarin
  • Insulin
  • Biologics
  • Methotrexate
  • Parkinson’s Disease Medications
  • Biophosphonates for Osteoporosis

Sources

• U.S. Food and Drug Administration – FDA
• Advising on missed or delayed doses of medicines – SPS NHS