Birth control pill overdose

Most birth control pills contain one of the following combinations of estrogen and progestin hormones:

• Ethynodiol diacetate and ethinyl estradiol
• Ethynodiol diacetate and mestranol
• Levonorgestrel and ethinyl estradiol
• Norethindrone acetate and ethinyl estradiol
• Norethindrone and ethinyl estradiol
• Mestranol and norethindrone
• Mestranol and norethynodrel
• Norgestrel and ethinyl estradiol

These birth control pills contain progestin only:

• Norethindrone
• Norgestrel

Other birth control pills may also contain these ingredients.

Here are several birth control medicines:

• Levonorgestrel
• Levonorgestrel and ethinyl estradiol
• Norethindrone
• Norethindrone acetate and ethinyl estradiol
• Norethindrone and ethinyl estradiol

Other birth control pills may also be available.

Symptoms of an overdose of birth control pills include:

• Breast tenderness
• Discolored urine
• Drowsiness
• Heavy vaginal bleeding (2 to 7 days after the overdose)
• Headache
• Emotional changes
• Nausea and vomiting
• Rash

Seek medical help right away, and call poison control. Do not make the person throw up unless poison control or a health care provider tells you to.

Stop using the birth control pills and use other methods to prevent pregnancy, if desired. The overdose is not likely to be life threatening.

Have this information ready:

• The person's age, weight, and condition
• The name of the medicine (ingredients and strength, if known)
• When it was swallowed
• The amount swallowed
• If the medicine was prescribed for the person

The local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

You can also get online poison help now at Poisonhelp.org. Just enter the product, poison, or medicine to get expert help.

A trip to the emergency room (ER) will probably not be necessary. If you do go, take the medicine with you to the hospital, if possible.

If an ER visit is needed, the provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests

Treatment may include:

• Activated charcoal (in extreme cases)
• Intravenous fluids (IV, given through a vein)
• Medicine to treat symptoms and reverse the effect of the drug

Serious symptoms are very unlikely. Birth control pills may affect the metabolism of other medicines, which can result in other, more serious symptoms or side effects.

Aronson JK. Hormonal contraceptives - emergency contraception. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:824-826.

Aronson JK. Hormonal contraceptives - oral. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:782-823.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.