I forgot to take a dose of my medicine: what should I do?
What to do when you miss a dose, why the answer depends on each medicine and how to stop it happening again.
In short
- The rule that applies to almost every medicine: do not take a double dose to make up for the one you missed.
- Every leaflet has an "If you forget to take..." section that tells you whether to take it when you remember or skip it.
- As a general guide, if your next dose is close, the usual advice is to skip the missed one and carry on with your normal schedule.
- Anticoagulants, insulin, epilepsy medicines, Parkinson's medicines and weekly medicines have their own rules: ask your pharmacist.
If you have forgotten to take a dose, the first thing is not to take double at your next dose. Then open the leaflet and look for the "If you forget to take..." section: that is where the manufacturer explains what to do with that particular medicine, because the answer is not the same for all of them.
Missing a dose now and then is very common, especially when someone takes several medicines at different times of day. In this article we explain how to decide safely, which medicines need extra care and what you can do so it does not happen again.
What should I do as soon as I realise I have missed a dose?
Stay calm, do not take two doses together and check the leaflet. All leaflets authorised in Spain follow a common template that includes an "If you forget to take..." section, and the sentence "Do not take a double dose to make up for a forgotten dose" appears in the vast majority of them.
- Check the time the dose was due and the time of the next one.
- Look for the "If you forget to take..." section in the leaflet. If you do not have the paper copy, you can read the official leaflet on CIMA, the information centre of the Spanish Agency of Medicines and Medical Devices (AEMPS).
- Follow exactly what it says for that medicine.
- If you are unsure, ring your pharmacy or ask your doctor before taking anything.
- Write the missed dose down so you can mention it at your next appointment.
Should I take the missed dose or skip it?
It depends on the medicine and on how long it is until the next dose. As a general guide, the NHS Specialist Pharmacy Service (SPS) in the UK says most medicines can be taken up to 2 hours late, and beyond that the decision depends on how many times a day they are taken.
| Situation | General guidance (SPS, NHS) |
|---|---|
| You are less than 2 hours late | For most medicines the dose can be taken |
| Medicine taken once or twice a day | Take it when you remember, unless the next dose is due within a few hours |
| Medicine taken more than twice a day | Skip it and take the next one at the usual time |
| Any medicine | Never take a double dose unless the prescriber tells you to |
This table is only a guide: the leaflet for each medicine is what counts. For example, on CIMA the leaflet for a generic enalapril says not to take the missed dose and to wait for the next one, whereas the leaflet for Sintrom (acenocoumarol) says to take it as soon as possible, unless it is almost time for the next one, and to tell the doctor at the next check how many doses were missed.
Which medicines need more care if a dose is missed?
For some medicines, a missed dose, or the wrong way of making up for it, can have greater consequences. With these it is always worth ringing the pharmacist or the team in charge of the treatment before deciding.
- Anticoagulants such as acenocoumarol: follow the leaflet and your monitoring record, and report missed doses at your next visit.
- Insulin: follow your diabetes team's instructions and never inject a double dose.
- Epilepsy medicines: they have specific rules depending on whether they are taken once or twice a day.
- Parkinson's medicines: timing is especially important; never take two doses together.
- Weekly methotrexate: the window for taking it late is one or two days; if more time has passed, ask for advice.
- Contraceptives, immunosuppressants and cancer treatments: these need their own instructions from the leaflet or the specialist.
What if I do not know whether the dose was taken or not?
If you are not sure whether the dose was taken, the safest option is usually not to repeat it and to ask the pharmacy, because taking it twice can be worse than skipping it. This doubt is very common in older people who take many medicines or who have memory problems.
If it turns out the dose was taken twice, see our guide on what to do if a tablet has been taken twice. To avoid the doubt in future it helps a great deal for each dose to be separate and visible: a pill organiser or a personalised dosage system (SPD) lets you check at a glance whether the pocket for that time is empty.
A practical example: Antonio forgets his morning tablet
Take the case of Antonio, 76, who takes a blood pressure medicine once a day in the morning, an anticoagulant in the afternoon and four other medicines. One day he realises at five in the afternoon that he did not take his morning tablet.
- He does not take two tablets the next day to make up for it.
- He looks for the "If you forget to take..." section in the leaflet for his blood pressure medicine and follows it: in some cases it will say to skip the dose and in others to take it if the next one is still a long way off.
- As he is unsure, he rings his pharmacy and explains which medicine it is and what time it was due.
- He takes his afternoon anticoagulant at the usual time and writes down the missed dose to mention at his next check.
- He talks to his daughter about how to organise his doses better so it does not happen again.
If missed doses keep happening, it is worth reviewing with the doctor whether the regimen can be simplified. You will find more ideas in our article on how to follow your dosage instructions without mistakes.
How can IMA Health help you avoid missing doses?
When someone takes many medicines, having them prepared by day and time reduces missed doses and doubts. At IMA Health we coordinate with a specialised pharmacy that prepares the medication in a personalised dosage system, separated by the day and time of each dose, and we deliver it to your home.
We also provide personalised follow-up to spot anything that does not fit and coordinate treatment changes with the pharmacy. If you would like to know more about this system, read what an SPD is and how it makes organising easier.
Sources
- AEMPS: Questions and answers on SmPC, labelling and leaflet (Spanish)
- CIMA (AEMPS): leaflet for Enalapril Cinfa 20 mg (Spanish)
- CIMA (AEMPS): leaflet for Sintrom 4 mg (Spanish)
- NHS Specialist Pharmacy Service: What should people do if they miss a dose of their medicine?
This article is for information only and does not replace advice from your doctor or pharmacist.