The general rule: take it as soon as you remember
For most medicines, the general guidance is: take the missed dose as soon as you remember — unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule.
⚠️ The one thing to never do
Never double up — do not take two doses together to make up for a missed one. For most medicines, this increases your risk of side effects without any benefit.
Why the timing of your next dose matters
Whether you should take a missed dose depends on how much time has passed and when your next dose is due:
- Less than half the gap until your next dose: Take the missed dose straight away. Then continue as normal.
- More than half the gap until your next dose: Skip the missed dose and continue with your regular schedule.
For example: if you take a medicine twice a day (every 12 hours) and you miss the morning dose at 8am, and you remember at 2pm (with the next dose due at 8pm):
- You are 6 hours late, with 6 hours until the next dose
- This is right at the boundary — in this case, skip the missed dose and take your evening dose as normal
Medicines that need special care when a dose is missed
Some medicines have specific advice that differs from the general rule:
Antibiotics (e.g. amoxicillin)
Take the missed dose as soon as you remember, unless it is almost time for the next one. Do not skip doses just because you feel better. Never double up. For twice-daily antibiotics, leave at least 6 hours between doses.
Oral contraceptive pills
Rules vary significantly depending on whether it is a combined pill or progestogen-only pill, and how many hours late you are. Check the patient information leaflet or ask your pharmacist — this is one where the specific guidance really matters.
Blood pressure medicines (e.g. ramipril, amlodipine)
Take as soon as you remember. If it is nearly time for the next dose, skip the missed dose. Do not take two together — a double dose can cause an unsafe drop in blood pressure.
Metformin (diabetes)
Take with your next meal if you missed the dose at a meal. Never take two doses at once. If you have completely missed a meal, skip that dose entirely.
Thyroid medicine (levothyroxine)
Take the missed dose as soon as you remember if it is the same day. If the next day, skip it and carry on. The effect of levothyroxine is cumulative over weeks, so one missed dose rarely makes a significant clinical difference.
🩺 Ask your pharmacist if you regularly miss doses
What happens if you miss doses regularly?
Most medicines need to maintain a certain level in your bloodstream to work effectively. Regularly missing doses can mean:
- Your blood pressure, blood sugar, or other measured values may not be well controlled
- Antibiotics may not clear the infection fully — and resistance can develop
- Preventive medicines (like aspirin or statins) may not provide the protection they should
- Symptoms may return or worsen
If you find it genuinely difficult to remember your medicines, speak to your pharmacist. There are practical solutions, and nobody should feel embarrassed about asking.
The bottom line
Take the missed dose as soon as you remember — unless it is almost time for your next dose. Then skip the missed one and carry on as normal. Never double up. And if you are unsure about a specific medicine, ask your pharmacist.