How to take a pill for the first time

Índice Show

If you’re taking combination birth control pills
If you’re taking a progestin-only pill
Combination pills
Progestin-only pills
How to swallow a pill
Don't try this at home
What you can do to help swallow pills more easily
Disclaimer:

Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — Written by Adrienne Santos-Longhurst on June 27, 2021

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Taking birth control pills is pretty easy — you just pop a tiny pill into your mouth and swallow.

There are two different types of birth control pills: combination pills (estrogen and progestin) and progestin-only pills. The type you take doesn’t change when you can start, but it does impact when you’ll be protected from pregnancy.

We’ll cover all that and answer your other Q’s about starting birth control pills below.

Anytime you want. But when you start affects how soon you’ll be protected against pregnancy.

Let’s break it down by pill type.

If you’re taking combination birth control pills

You can start combination pills anytime, but here’s how timing impacts how soon you’ll be protected against pregnancy:

If you start within 5 days after your period starts: You’ll be protected right away, as long as you start taking your pills within 5 days of starting your period. That means, if you get your period on Sunday morning and start the pill any time before Friday morning, you’ll be protected right away.
If you start any other time: Starting at any other time means that you’ll need to take it for 7 consecutive days before you’re protected against pregnancy. During this time, you’ll definitely need to use another method — like condoms or another barrier — if you’re having penis-in-vagina sex and don’t want to get pregnant.

If you’re taking a progestin-only pill

Progestin-only pills, aka minipills, can be started any time, depending on the brand.

These pills work fast and offer protection against pregnancy after two consecutive pills (48 hours). If you don’t want to wait 48 hours before having sex, use another method of birth control in the meantime.

The only exception is if you’re taking the progestin-only pill Slynd.

If you start taking Slynd on the first day of your period, you’ll be protected right away. If you start at any other time, then protection doesn’t take effect for 48 hours.

Again, this depends on the type you’re taking. Dosing schedules vary between types and brands.

You don’t need to take the pill with food. But, if you’re prone to nausea, it’s best not to take them on an empty stomach.

As long as you follow the recommended dosing schedule for the type you’re taking — which we’ll get to in a sec — you can choose a time of day to take them that works for you.

This should be a time that’s convenient and easy to incorporate into a routine, so you won’t forget (think: with your morning coffee or before you brush your teeth).

Let’s look at the dosing deets for each type.

Combination pills

You don’t ~technically~ need to take combination birth control pills at the same time every day, but doing so is recommended to help you get into the habit and not forget.

How many days in a row you take a pill depends on the brand. That’s because combo pills come in different dosing packs, from 21 days up to 365 days.

With most brands, you take at least 3 weeks of active pills and 2 to 7 days of inactive pills or no pills at all. This is called cyclical dosing, and most people get a period during this week “off” the active pills.

There are also brands that offer:

Continuous dosing. This involves taking an active pill every day without the need for inactive pills.
Extended dosing. This involves short breaks three or four times per year, where you take inactive pills or no pills at all.

Here’s how to take each:

21-day pack: Take one pill per day for 21 days, and wait a week before starting a new pack. You’ll get a period the week you’re not taking the pill.
28-day pack: Take one pill per day for 28 days, and start a new pack on day 29. Depending on the brand, the first 21 or 24 pills contain estrogen and progestin. The remaining pills might be estrogen-only, be inactive, or contain a dietary supplement. You should get a period during this time.
91-day pack: Take one pill per day for 84 days. Depending on the brand, up to the last 7 pills will be inactive or estrogen-only, which is when you’ll get your period. With this dosing, you only get a period every 3 months.
365-day pack: Take one pill per day every day for an entire year. With continuous daily dosing of active pills, you shouldn’t get a period for the entire year.

Progestin-only pills

Unlike combination pills, it does matter when you take progestin-only pills.

Progestin-only pills need to be taken within the same 3 hours every day to be effective.
This means, if you take your pill at 8 a.m., taking it after 11 a.m. the next day puts you at risk for pregnancy.

Most progestin-only pills come in 28-day packs and all 28 pills are active. To be protected, you have to take all 28 without a break.

You might get a period during the last week of the pack, but many people only have mild spotting or no bleeding at all.

The brand Slynd is slightly different when it comes to its dosing schedule. As long as you take one pill per day, Slynd progestin-only pills don’t need to be taken within the same 3 hours to be effective. Their packs have 24 active pills and 4 inactive pills.

As long as you’ve only missed one pill, it’s NBD. Just take it as soon as you remember, even if you have to double-up.

There could be. Like any medication, the pill can cause side effects in some people. Most people who take the pill don’t have any problems, though.

Side effects, if any, usually only last 2 to 3 months as your body adjusts to the hormones.

After starting the pill, you might experience:

headaches
sore breasts
nausea
period changes

FYI, some of the pill’s side effects can be a good thing. The pill may help with:

Birth control pills are generally safe, but they can increase your risk of blood clots.

Blood clot warning signs
Birth control-related blood clots are rare, but it’s wise to know what to watch for. See a healthcare professional right away if you experience:
chest pain or discomfort
sudden severe back or jaw pain, sweating, and nausea
trouble breathing
aching in your leg
severe abdominal pain
sudden severe headache
vision changes

Very!

We’re talking up to 99 percent effective when taken exactly as directed, according to Planned Parenthood.

It’s your body, so you can stop if you want to. Just remember that stopping means you can get pregnant. So, unless that’s your intention, you’ll need to use another birth control method.

Depending on your reasons for stopping, it might be a good idea to talk with a healthcare professional first.

If you’re looking to switch birth control, a healthcare professional will tell you how to do it safely, since some overlapping may be required.

You’ll also want to talk with a doctor first if you’re on the pill for medical reasons other than pregnancy prevention, like polycystic ovary syndrome or endometriosis.

If you want to try to get pregnant, it could take some time, depending on the type of pill used.

When you go off the pill, your body will need some time to adjust to the change in hormones — like it did at the start. This means you might have spotting or irregular periods for a while.

Starting birth control pills usually goes off without a hitch, and most people don’t have any side effects.

Follow the instructions given by your healthcare professional, and read the info that comes with your pills to know exactly when protection kicks in for your particular brand.

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.

Last medically reviewed on June 27, 2021

Harvard Health Blog

By Heidi Godman, Executive Editor, Harvard Health Letter

The expression that something is "a hard pill to swallow" isn't just a metaphor. Swallowing pills can be difficult and downright unpleasant. It causes one in three people to gag, vomit, or choke. That may keep people from sticking to their medication routines, which can make them sicker.

"We often see people who can swallow food and liquid just fine, but have difficulty with pills. Some people have an aversion to swallowing pills, and others have physical issues that affect their ability to swallow," says Denise Ambrosi, director of the Speech-Language Pathology Department at Harvard-affiliated Spaulding Rehabilitation Hospital.

How to swallow a pill

A study by researchers from the University of Heidelberg in Germany may help people with pill swallowing difficulties. They suggest two techniques that can help people improve their ability to get medicine down. Their report was published in the Annals of Family Medicine.

Pop-bottle method to swallow pills. Image Credit: Annals of Family Medicine

The pop-bottle method is designed for swallowing tablets:

Fill a plastic water or soda bottle with water.
Put the tablet on your tongue and close your lips tightly around the bottle opening.
Take a drink, keeping contact between the bottle and your lips and using a sucking motion to swallow the water and pill. Don't let air get into the bottle.

Researchers asked about 140 people with difficulty swallowing pills to test this method with their eyes closed, swallowing large and very large pills. The result: a 60% improvement in swallowing over the old method of just taking a sip of water from a cup and trying to swallow.

Study participants had even more success with a technique for swallowing capsules called the lean-forward method:

Lean-forward method to swallow pills. Image Credit: Annals of Family Medicine

Put a capsule on your tongue.
Take a sip of water but don't swallow.
Tilt your chin toward your chest.
Swallow the capsule and water while your head is bent.

This technique showed an improvement of 89% over the old method of taking a sip of water from a cup and trying to swallow.

You can download a handout demonstrating these techniques from the Annals of Family Medicine.

Don't try this at home

But don't rush to try out these pill-swallowing techniques, warns Ambrosi. "The study mainly found that people's perceptions of pill swallowing changed," she says. It's true; researchers only asked participants if their pills went down easier, they didn't get any images of what was happening physiologically during the swallowing tests, or measure physical differences.

So it's not a given that one of these methods will work for you or be safe for you, especially if you have a hard time swallowing pills. "You'll need a thorough assessment first. Maybe there's something causing the swallowing problems that would only be identified with an instrumental swallowing assessment," says Ambrosi.

Difficulty swallowing is called dysphagia. It can be caused by problems with nerves or muscles. Quite a few of those are involved in the swallowing process — 25 pairs of muscles in the mouth and throat help prepare your food for swallowing. When you swallow, your airway closes and you stop breathing for a moment. Trouble with the coordination of any of the nerves and muscles involved in the process can lead to choking or getting food or liquid into your lungs, potentially causing a type of pneumonia.

What you can do to help swallow pills more easily

Until you know what's behind your swallowing issues, here are a few things you can do to make swallowing medicine a little easier:

Put a pill in applesauce or pudding. The texture can make it easier to swallow pills whole.
Grind a pill into a powder and add it to applesauce or pudding.
Cut a pill with a pill splitter and swallow the smaller pieces one by one.

Make sure you ask your pharmacist if it's okay to cut or grind a medication. Timed-release or enteric-coated medicines shouldn't be broken apart. It may also be possible to get your medicine in another form, such as a powder, cream, or liquid, so don't hesitate to ask.

If you have trouble swallowing pills or anything else, don't put off getting an evaluation. Start with your primary care physician, who will likely refer you to an ear, nose, and throat specialist or to a speech-language pathologist for a swallowing assessment. Facing the possibility that you have a swallowing disorder may be a hard pill to swallow, but learning ways to overcome it will make your future of taking medication a lot safer.

Image: agrobacter/Getty Image

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio

View all posts by Heidi Godman

Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Comments

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Swallow pills is very disgusting for. I don`t like to take this pills.But after knowing these two tricks about swallow pills it has become very easy for me.
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I find swallowing circle shaped pills, a tad difficult.
But rolled shaped I have no problem just can not work out why.

really nice information! i have always have a problem when taking those pills. now i will keep sure to try this tips. thank you so much!

Nice information, good stuff with good ideas and concepts, lots of great information and inspiration, both of which we all need; ,……!

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Here I am at age 85, waiting for our 50th wedding anniversity next March. My height is now 72 inches and my weight has come down to 174lbs. My hair is grey, straight and ample. My skin is smooth,wrinkle-free, without moles, pimples or lines. But I do have circles under my eyes. There are many deficiencies in my bodily functions. Reading glases, COPD, prostatitis, incipient liver problems and diabetes, triple bypass, heart disease, a crushed vertebra, walking straight. My sexual activities have reduced to day-dreaming, recalling my three middle decades of my life

when I was rampant continually, but now un able to coerce my wife to share intercourse occasionally. I need to devise some way of assuring her that sex would not kill me!

I didn’t know there are others too who can’t swallow pills !! it’s nightmare for me , very annoying . I surely try these technique hope it helps thanks

Thanks for this article and the comments. I have difficulty swallowing x 2… scleroderma and a site from a tracheostomy. I found Greek (thicker) yoghurt helps and it’s easy to keep fresh in the fridge. Also, I found small high-quality caplets of vitamins (Rainbow Light Mini Tablets, calcium/magnesium (New Chapter Bone Strength), and soft gel ibuprofen (Walgreens and other stores). Best regards to all.

My mother and I had this problem with overlarge vitamin pills. A very simple solution (overlooked for years by us) was to buy the chewable vitamins that are berry flavored with the consistency of gummy bears.

Although I appreciate the thoughtful article, I do think that the method we are using up here in Canada has a close to 100% success rate, and people love it. And we have posted a training video — perhaps people who do not succeed with the pop bottle system might like to take a look:
research4kids.ucalgary.ca/pillswallowing

I’m an SLP and I have terrible difficulty with pills of any size. So bad that I am in the percentage of those that gag the pills back into the oral cavity and often vomit . I also gag when brushing my teeth so my gag is hypersensitive . However, I have found the Valsalva in conjunction with the Masako techniques help aide swallowing pills for me but I would say at about 75% . So will definitely try your bento ones techniques about the water bottle as I have tried the second me to ones technique but has not worked for me

I’m a SLP and I have difficulty swallowing pills. I always thought it was a psychological thing but I had to have my esophagus stretched last year because I all of a sudden couldn’t swallow one night.

I have MS and have trouble swallowing pills . I found your article very informative . Thanks for the tips.

It’s hard to imagine that somebody may have problems with swallowing medicines, but this article may be useful and helpful for people who had not such an experience before)

Just a tip for other who might read this. I find that swallowing just one pill will always get stuck. But I was very surprised to learn that swallowing 2-3 pills at a time is MUCH easier!! I know, it doesn’t make sense, but it works, try it out.

This is amazing! I have always battled to swallow pills. Both these ways of swallowing have helped me tremendously. Thank-you!

My trick is to take a mouthful of food and chew it really well. Then put the pill in and swallow it all together. I never have a problem. If it’s something really delicious this method can encourage a child like nothing else.

I use this technique to take pills when I am lazy to go and get a cup of water.

These harvard newsletters are invaluable and a great source of knowledge. I was especially pleased to learn about difficulty in swallowing. I have a paralysed larynx and an atrophied vocal cord so even eating normal food is a difficulty. Once again many thanks indeed.

With my dad with LBd that monster form of Parkinson’s I have to take a bottle cap place the pills in so he can take them. He has to be told to tilt his head so the swallow happens. When he was in the rehab I call dying centers they presumed he had a swallowing silent aspiration. I knew it was different. He has had a narrow opening in throat like I do from sinus conditions. He has had clear chest x’rays. I always appreciate learning everything I can to aide my dad and myself live a better life. Sincerely Michelle who was just a associates of science in medical administration studies who feels more like a Nurse than daughter.

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