Yes, you can drink on birth control: alcohol is not one of the things the FDA pill label or CDC guidance lists as making the pill, patch or ring less effective. The risk comes from what drinking can lead to, mainly throwing up soon after a pill or forgetting pills. For the combined pill, CDC says one bout of vomiting does not need an extra pill or backup, but vomiting or diarrhea that lasts 48 hours or more does need backup, and some pack leaflets are stricter. If you missed pills and had sex without a condom, Plan B is an option.
Does alcohol make birth control less effective?
Alcohol is not listed as something that lowers the effectiveness of the pill. The FDA label for a common combined pill (Aviane) names the products that can: some antibiotics, rifampin, some seizure medicines, some HIV medicines, and St. John's wort. Alcohol is not on that list, and CDC's contraception guidance does not name it either.
So based on these sources, a drink with dinner, or a few at a party, is not expected to stop your pill, patch or ring from working. What matters is whether you still take your pill on time and whether you keep it down.
I threw up after drinking. Do I need to take another pill?
It depends on the type of pill, and for the combined pill the guidance is not all the same. Check the leaflet in your pack, since it gives the rule for your brand.
- Combined pill (estrogen and progestin), CDC guidance: you do not need to take an extra pill. Keep taking 1 pill a day at your usual time. You need condoms or no sex only if vomiting or diarrhea lasts 48 hours or more, until you have taken 7 pills in a row after it stops.
- Combined pill, pack leaflets: some are stricter. The patient leaflet for Aviane, for example, says that if you vomit within 4 hours of a pill, follow its missed-pill instructions. If your leaflet says this, follow it.
- Progestin-only pill (minipill): if you vomit within 3 hours of a pill, CDC says take another pill as soon as you can. For norethindrone or norgestrel pills, use condoms until 2 days after the vomiting stops. For drospirenone pills (Slynd), CDC says backup is needed only if vomiting or diarrhea lasts more than 24 hours, then for 7 days after it stops.
- Patch or ring: CDC's vomiting rules are written only for pills, and the patch and ring are not swallowed. What CDC does cover for them is that the patch stays on and the ring stays in.
What if I forgot my pill because I was drinking?
Forgetting is the more common problem. For the combined pill, CDC's rules are:
- 1 pill late or missed (less than 48 hours since you should have taken it): take it as soon as you remember, even if that means 2 pills in 1 day. No backup needed.
- 2 or more pills in a row missed: take the most recent missed pill now, throw away the other missed ones, then go back to 1 a day. Use condoms or skip sex until you have taken 7 pills in a row.
- Missed pills in the last week of hormone pills: skip the hormone-free week. Finish the hormone pills in your pack and start a new pack the next day.
- Progestin-only pill: norethindrone or norgestrel counts as missed if you are more than 3 hours late. Take 1 as soon as you can and use condoms until you have taken pills on time for 2 days in a row.
- Patch off or ring out for 48 hours or more: put a new one on or in as soon as you can and use backup until it has been in place for 7 days in a row.
When should I think about Plan B?
CDC says emergency contraception should be considered if you missed 2 or more combined pills in the first week of a pack, or had vomiting or diarrhea that started in the first week, and had sex without a condom in the previous 5 days. For the progestin-only pill, CDC says to consider it if you had sex without a condom after a missed or vomited pill. If you are unsure, ask a pharmacist.
Plan B One-Step (levonorgestrel) is sold over the counter. Its label says to take it as soon as possible within 72 hours after sex, and the sooner the better. If you vomit within 2 hours of taking it, the label says to call a healthcare professional to ask whether to repeat the dose.
If you are on the pill, CDC's advice points to emergency contraception other than ulipristal (ella), because ella and the hormones in your regular birth control might make each other work less well. After Plan B, CDC says you can keep taking your pill right away, but use condoms or skip sex for 7 days. If you do not have a period within 3 weeks, take a pregnancy test.
When should you get care?
In an emergency, call 911Call your doctor or pharmacist the same day if vomiting or diarrhea lasts 48 hours or more, or if you had sex without a condom after missed or vomited pills, since Plan B works best the sooner you take it.
Call 911 for signs of a clot, heart attack or stroke while on the pill: sudden or crushing chest pain, sudden shortness of breath, coughing up blood, pain in your calf, a sudden severe headache, sudden vision changes, weakness or numbness in an arm or leg, or trouble speaking.
Call 911 if someone who has been drinking is hard to wake, is breathing slowly, is confused, or is vomiting blood. Put them on their side in case they throw up, and do not try to make them vomit. When in doubt, call. Poison Help is 1-800-222-1222.
How our AI doctor decides when to send you to care ›Any other reasons to be careful with alcohol on birth control?
The pill does not protect against STIs, and the Plan B label says the same. If drinking means a condom gets skipped, an STI test may matter as much as pregnancy risk.
Smoking raises the risk of serious heart and blood vessel problems on the combined pill, and the FDA label says people over 35 who smoke should not take it. That warning is about smoking, not alcohol, but it is worth knowing if you smoke when you drink.
Common questions
Can I drink alcohol on birth control?
Yes. Alcohol is not listed by the FDA label or CDC as something that weakens the pill, patch or ring. The risk is indirect: vomiting soon after a pill or forgetting pills. Follow the vomiting and missed-pill rules for your type of pill.
Does a hangover affect the pill?
Feeling rough does not change how the pill works. It only matters if you throw up or skip a pill. On the combined pill, CDC says a short bout of vomiting does not need backup, but 48 hours or more does. Some pack leaflets are stricter, so check yours.
Can I take my pill while drunk?
Taking it on time is better than skipping it. Alcohol is not listed as an interaction on the pill label. If you are worried you will forget, set an alarm or take it before you go out, as long as that stays close to your usual time.
I threw up the next morning. Was my pill already absorbed?
For the combined pill, CDC says you do not need an extra pill after vomiting, and you need backup only if it goes on for 48 hours or more. Some pack leaflets, like Aviane's, say to treat vomiting within 4 hours of a pill like a missed pill, so check yours. For the progestin-only pill, vomiting within 3 hours means take another pill.
Does alcohol affect Plan B?
The Plan B label does not list alcohol among the things that reduce its effectiveness. It does say to call a healthcare professional if you vomit within 2 hours of taking it, to ask whether to repeat the dose.
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with questions about a medical condition. If you think you may have a medical emergency, call 911.