Accidentally Took Meds At Night Instead Of The Morning

In our latest question and answer, the pharmacist discusses what to do if you accidentally take your medication at the wrong time.

Question

My son took 54 mg of Concerta and 50 mg of sertraline accidentally at night instead of in the morning. Can he take it again in the morning or do we have to skip it until the following morning?

Asked by Elyssa On Sep 29, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 29, 2022
Last updated Jun 27, 2024

Key points

  • Taking your medication at the wrong time of the day is a fairly common dosing error. How to get back on your usual schedule depends on the drug you are taking.
  • For some drugs, it isn't recommended to take more than one dose in 24 hours, and you may need to wait and miss your usual dosing time to get back on track.
  • For other drugs (i.e. oral contraceptives), it may be recommended to continue taking your pills at your usual time, even if it means taking two doses in 24 hours.

Medication dosing errors are bound to happen from time to time, and it can sometimes be difficult to discern exactly what to do if it does happen, or how to get back on schedule.

The most common type of dosing error is 'double-dosing', or accidentally taking two doses of the same medication. This can happen for many reasons, such as simply forgetting a dose was already taken, or when someone responsible for giving medication to another isn't aware a dose was already administered, for example.

Another type of dosing error is what you described, taking the medication at the wrong time of day (i.e. at night instead of the morning).

How serious these errors depend on many factors, including who took the doses, the type of medication it was, etc...so there is no blanket recommendation for how to get back on your usual schedule.

These things often need to be considered on a case-by-case basis, based on all the factors involved (e.g. patient, drug, dosing interval, the disease being treated, etc...).

For some drugs (such as Zoloft and Concerta you mentioned in your question), you generally want to avoid taking more than 2 doses in 24 hours, and it may be prudent to wait until 24 hours have passed to get back on your usual schedule. If you have been on drugs like this for a few months, waiting some extra time between doses is very unlikely to cause any issues.

For other drugs, like birth control pills, the recommendation would be to continue taking your pills on your usual schedule, even if it means you take two doses in 24 hours.

I discuss Zoloft and Concerta in the next question but if you have any questions about other drugs, please reach back out again! We'll be happy to provide guidance on any and all drugs.

Mis-Dosing Zoloft And Concerta

In your situation, two prescription medications, Zoloft (sertraline) and Concerta (methylphenidate) were taken at night instead of in the morning.

As a general rule of thumb, you should try and avoid taking extra doses of medication within your usual dosing window.

If you, for instance, decided to take Concerta and Zoloft again in the morning, after already dosing the evening before, you could increase the risk of side effects occurring.

This is especially true as Zoloft and Concerta are intended as once-daily medications. You would essentially be taking a double dose of each within a short amount of time.

You have to weigh this against what would happen if you skip the morning doses. Will you go through withdrawal? With the effect of the medication wear off?

If you have been on Concerta and Zoloft for a good amount of time (at least a few weeks), the risk of withdrawal after only a day or two of missed doses would be extremely uncommon.

They are both likely at 'steady-state' concentrations in your body, and, for most, it is likely to be riskier taking extra doses than it would be to miss a dose for these two medications.

Options

So, essentially, there are two choices to make:

  • Take your morning dose of Concerta and Zoloft (after already taking them the last evening) and risk the increased side effects.
  • Skip the morning dose of the medications, and continue on your normal schedule the next day, although this will result in more than a 24-hour time period elapsing between doses.

You should discuss your options with your personal doctor and/or pharmacist. Everyone's medical situation is different, and you should consult with someone that has your complete medical history.

As mentioned above, however, it generally would be recommended not to take extra doses in your usual dosing interval (i.e. more than one dose of Zoloft and Concerta in a 24-hour time period) due to the increased risk of side (e.g. cardiovascular complications with Concerta), but your situation may dictate another course of action.

This recommendation doesn't apply to all drugs, so please reach out again if needed!

Final Words

Thanks so much for your question!

References

  • [Oral contraception - doses and way of administration], PubMed
  • Concerta Prescribing Information, AccessFDA
  • Zoloft Prescribing Information, AccessFDA
  • A 10-year review of single medication double-dose ingestions in the nation's largest poison control system, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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