Missed a Dose of Your Medication? What to Do, and What Not to Do

For most medicines taken once or twice a day, take the missed dose as soon as you remember, unless your next dose is due within a few hours; in that case skip it and carry on as normal. Never take a double dose to make up for one you missed.

That is the general rule. It does not apply to every medicine, and for a few, such as insulin, warfarin, epilepsy and Parkinson's medicines, the advice is different. The leaflet in your medicine's box is the first place to check.

This is general information from NHS guidance, not advice for your situation. If you are unsure, ask your pharmacist, doctor or the team that prescribed the medicine.

What should I do if I miss a dose?

The NHS Specialist Pharmacy Service (SPS), which advises pharmacists across England, says to start with two sources: the Patient Information Leaflet that comes with the medicine, where missed-dose advice is usually in the "How to take" section, and the NHS website's medicine guides.

If neither answers it, SPS gives this general advice for most medicines:

• Less than 2 hours late: "For most medicines, it is acceptable to take a dose up to 2 hours late."
• More than 2 hours late, for a medicine taken once or twice a day: "Take the missed dose as soon as it is remembered, as long as the next dose is not due within a few hours. Then continue taking the medicine at the usual time(s)."
• More than 2 hours late, for a medicine taken more than twice a day: "Skip the missed dose and wait until the next dose is due."

And in every case: "Never take a double dose to make up for a forgotten dose, unless advised by a prescriber."

The US National Library of Medicine's MedlinePlus gives similar wording for metformin: "Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one."

Why is the advice different for different medicines?

Because the safest choice depends on the medicine. The NHS guides for three widely used medicines show this:

Medicine	What the NHS guide says if you miss a dose
Amlodipine (blood pressure)	"Skip the missed dose and take your next dose as usual."
Atorvastatin (cholesterol)	"Skip the dose you missed and take your next dose at the usual time."
Metformin, once a day (diabetes)	"Take it as soon as you remember, unless it's nearly time for your next dose."

All three say the same thing about catching up: "Do not take 2 doses to make up for a missed dose."

So if you take more than one medicine, the right move after a missed morning can be different for each tablet. That is why the leaflet matters more than a rule of thumb.

Can I take a double dose to catch up?

No, unless your prescriber has told you to. SPS explains the risk in both directions: "Taking a medicine at the wrong time may reduce its efficacy. Taking subsequent doses too close together may also increase the risk of side effects."

The same logic applies when you cannot remember whether you took a dose at all. Taking another "just in case" risks the double dose the guidance warns against. If you are unsure, check with a pharmacist before taking anything.

Which medicines need special advice?

SPS lists medicines where a missed or late dose carries more risk. The list is not complete, and in each case your own care team's instructions come first.

• Antiseizure (epilepsy) medicines. Citing the Epilepsy Society: a once-daily dose should be taken as soon as it is remembered; a twice-daily dose "can be taken if it is within 6 hours after it was due." If later, skip it. People who miss doses should avoid activities where a seizure could be dangerous, such as driving.
• Parkinson's medicines. "Even a delay of 30 minutes could be serious." Parkinson's UK's advice is to take the forgotten dose when you remember and move the later doses back; contact your Parkinson's nurse or clinic if you are unsure.
• Insulin. Follow the instructions from your diabetes team, check glucose more often for the next 24 hours, and never take a double dose.
• Once-weekly methotrexate. Citing the NHS guide, SPS says it can be taken a day or two late; if it is 3 or more days late, skip that week's dose.
• Warfarin. Under the Yellow Book advice, if you remember before midnight you can still take it; after midnight, wait for the next dose. Note the missed dose in your record and tell the clinic at your next blood test.
• The contraceptive pill. What to do depends on the pill type and how many were missed; protection against pregnancy may be affected.
• Transplant and cancer medicines. Ask your specialist doctor, nurse or clinic.

What if I keep forgetting my medicine?

You are far from alone. A widely cited review in Mayo Clinic Proceedings (Brown and Bussell, 2011) puts it at about 50%: "approximately 50% of patients do not take their medications as prescribed."

A few things help:

1. Tell your pharmacist or doctor. Frequent missed doses are worth mentioning; sometimes a dosing schedule can be simplified.
2. Tie the dose to something fixed, like breakfast or brushing your teeth.
3. Use a pill organiser so you can see whether today's dose has gone.
4. Use a reminder that reaches you at the time. SPS's own guidance on adherence points to reminder systems as one of the tools that can help when memory is the problem.

If you look after an older parent, the same applies to them, with one more difficulty: you are often not there to see whether the dose was taken.

How ReminderIt can help

ReminderIt places a real phone call at the exact time you choose, in a natural voice that reads your message, for example "It is 8pm. Time for your metformin, with dinner." A call is harder to miss than a notification. If the call is missed, you get a WhatsApp message, so you find out while there is still time to follow your medicine's missed-dose rule.

You can set it up by sending a WhatsApp message (text, voice note or photo) or on the website, and there is no app to install. You can also set medicine calls for a family member, such as a parent who lives on their own; they confirm first.

There is a 7-day free trial with 7 free reminder calls (3 if your number is in a country where calls cost more). After that it is one plan: $7 a month, or ₹299 a month in India, with annual and 2-year options.

The short answer

If you miss a dose, check the leaflet first. If it says nothing, the general NHS guidance is: up to 2 hours late is usually fine; for once- or twice-daily medicines, take it when you remember unless the next dose is due within a few hours; for medicines taken more often, skip it. Never double up. Epilepsy, Parkinson's, insulin, warfarin, methotrexate, the pill, and transplant or cancer medicines have their own rules, so ask your care team.

Sources: NHS Specialist Pharmacy Service, Advising on missed or delayed doses of medicines (updated March 2025); NHS medicine guides for amlodipine, atorvastatin and metformin (If you miss a dose); MedlinePlus, Metformin (What should I do if I forget a dose?); Brown MT, Bussell JK, Medication adherence: WHO cares?, Mayo Clinic Proceedings (2011, abstract).