Pharmacy Corner
Pills, Patches & Rings Birth control pill

  1. What is the difference between 21 and 28-pack birth control pills? What about 24/4 or 84-pack pills?
    Most birth control pills come in a 21-day and 28-day pack that contains 21 days of active pills. The 28-day pack contains 7 days of “placebo” or sugar pills that contain no active ingredient and are a different pill colour than the active pills. They are a reminder pill for women so they remember to take their pills every day. You don’t have to take these sugar pills for your birth control pills to work.

    Some women may take birth control pills with 24 active pills and 4 sugar pills. Other women may be taking birth controls ‘continuously” where they take a pill each day for 84 days, and then have a pill-free break for 7 days. This will reduce common side effects of birth control pills and also result in less frequent periods (~4 times per year). Talk to your healthcare provider if you are interested in these options.
  2. Can I take the birth control pill with food? With alcohol?
    The pill can be taken with or without food. It is easier to take your pills when you do something at the same time. Many women will take their pills with their breakfast meal or when they brush their teeth because this makes it easier for them to remember.

    You can drink alcohol while on the birth control pill.
  3. What side effects can I expect when taking birth control pills?
    The most common side effects from the birth control pill are:1,4
    • Nausea
      • Take the pill with food to reduce the amount of nausea you are experiencing. If it continues to bother you, talk to your doctor or nurse practitioner about switching to a different pill
    • Headache
      • Tends to get better with time and typically occurs during your “off week”. If it is bothersome, talk to your doctor or nurse practitioner about options available
    • Breakthrough bleeding or spotting
      • Most often occurs within the first 3 months of starting the pill. Your bleeding should go back to a regular cycle as your body gets used to the pill
  4. What should I do if I am late for one pill of my birth control (<24 hours since your last pill)?
    Take the pill immediately, and resume your regular schedule. You are still protected and do not need to take emergency contraception (ie. “morning after” pill).2 Continue taking one pill a day at the same time you were previously taking.
  5. What should I do if I missed one or more of my birth control pills (≥24 hours since your last pill)?
    If it has been longer than 24 hours since you last took your pill, then consult your pharmacist or healthcare provider for advice.

SOS has a great tool that can help with missed pills, and you can access it at S.O.S (Stay on Schedule)

  1. I forgot to start my new pack and it’s been more than a day late. What should I do?
    Start your new pack as soon as possible and continue taking 1 pill per day until the end of the pack.2 If you have sex, use back-up methods, such as a condom, until you have taken the birth control pill again for 7 consecutive days. Consider taking emergency contraception (ie. “morning after pill”) if you had unprotected sex within the last 5 days.2
  2. I’ve started bleeding but it is not time for my period yet. Am I pregnant?
    Breakthrough bleeding, also known as spotting, is a common side effect of birth control pills. It occurs most often during the first 3 months of starting birth control and tends to get better with time. Spotting does not mean you are pregnant or that the pill is not working. You are still protected as long as you take your pills everyday without missing any.2,4
  3. I haven’t had my period yet and I’m on my “off-week” or taking “sugar pills”. Am I pregnant?
    As long as you take the pills every day without missing any, then you are likely not pregnant. The pill is more than 99% effective if used perfectly.1 It is common for some women to not get a period during their “off week”.1 Continue to take the pills everyday as directed and talk to your prescriber if you continue to not have your period and it is concerning to you.
  4. Will I gain weight while taking birth control pills?
    Studies comparing birth control pills to placebo (sugar) pills showed no weight gain for women taking birth control pills.1
  5. Can I start taking birth control pills if I’m a smoker?
    It is not recommended to take combined birth control pills if you are over 35 years old and a smoker due to an increase risk of having a heart attack and stroke.1 Taking progestin-only birth control pills (Micronor®) may be an option if you are a smoker. Please ask your doctor, nurse practitioner, or pharmacist for more information to determine if that is a suitable option for you. These healthcare professionals are also great resources if you are looking to stop smoking.
  6. What should I do if my home pregnancy test comes back positive and I’m taking birth control pills?
    Please see your doctor or nurse practitioner to confirm if you are pregnant. If pregnant, stop taking your birth control pills. Taking birth control pills will not harm your baby but it will not prevent a pregnancy after it has occurred.
  7. What is the minipill (Micronor®)?
    The “minipill” is a birth control pill that does not contain the hormone estrogen. It is used for women who want to take birth control but should not be taking estrogen, such as:
    • Women who are over 35 years old and smoke
    • Breastfeeding women seeking birth control immediately after giving birth
    • Women experiencing migraines
    Women taking the mini-pill must take the pill at the same time every day. It is less forgiving for late and missed pills than the traditional combined birth control pill.