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Starting Cyclafem and What to Do About Missed Pills

Starting Cyclafem for the First Time

There are two different recommended ways to start Cyclafem (any strength) for the first time:
  • Sunday start: Start Cyclafem on the first Sunday after your period starts, even if you are still having your period. Starting on Sunday may decrease the chance that you will have your periods on the weekends, although not all women find this to be the case. You will need to use a backup method of birth control for the first seven days of the first pack.
  • Day 1 start: Start Cyclafem on the first day of your period (within 24 hours of the start of bleeding). You will be protected from pregnancy from the start, and no backup method of birth control is needed. If your period happens to start on a Sunday, treat this as a day 1 start, not a Sunday start. 

If you choose a Sunday start, you will start every pack of Cyclafem on Sundays. If you choose a day 1 start, you will start each pack on your initial start day (for instance, if you first started Cyclafem on a Tuesday, you will start every pack on a Tuesday). 

Some healthcare providers may suggest other ways to start Cyclafem, such as in the middle of the cycle. Make sure to follow your healthcare provider's instructions in such situations.

What If I Miss a Dose of Cyclafem?

It is important that you take Cyclafem every day and at the same time each day, even if you do not have sex very often. Missing pills increases the risk of pregnancy. What you should do if you miss pills depends on how many you have missed, if you are a day 1 starter or a Sunday starter, and when in the cycle the pills were missed.
Some general instructions for missed pills include the following:
  • If you miss one of the first 21 pills, take the missed pill as soon as you remember and take the next pill at your regular time, even if this means taking two pills at once. You do not need to use a backup method of contraception, as you will be adequately protected against pregnancy.
  • If you miss two pills in a row during the first or second week of the pack, take two pills on the day you remember and two pills the next day. This should get you back on your regular schedule. You must use a backup method of contraception, such as condoms, if you have sex in the seven days after you restart the pills.
  • If you miss two pills in a row during the third week of the pack (or three or more pills in a row during weeks one through three), your instructions will vary, depending on whether you are a day 1 starter or a Sunday starter.

If you are a day 1 starter, throw out the rest of the pack and start a new one right away. If you are a Sunday starter, take one pill every day until Sunday. On Sunday, throw out the pack and start a new one (this keeps you on track as a Sunday starter).  


Either way, you need to use a backup method of contraception for a week. You may not have your period as usual this month, since you have skipped the pills that do not contain any hormones. 
  • If you miss any of the last seven pills (the fourth week of the pack), throw away the pills you missed and continue as usual. Missing these pills will not increase your risk of pregnancy, as long as you start your next pack on time. No backup contraception is necessary.
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