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.
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?
Sep 29, 2022- Accidental dosing errors like taking medication at the wrong time of day need to be handled case-by-case depending on the specific medication involved. For medications like Zoloft and Concerta, it's generally better to skip your next scheduled dose rather than take two doses within 24 hours, since taking extra doses increases the risk of side effects. You should contact your doctor or pharmacist with your specific medication and situation to get personalized guidance on how to get back on schedule.
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? Will 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 & sources
Glossary — Terms in This Answer
- Dosing error
- A mistake in taking medication, such as taking the wrong amount or at the wrong time.
- Double-dosing
- Accidentally taking two doses of the same medication within a short period of time.
- Dosing interval
- The amount of time that should pass between doses of a medication.
- Sertraline
- The generic name for the medication Zoloft, used to treat depression and anxiety.
- Methylphenidate
- The generic name for the medication Concerta, used to treat attention deficit hyperactivity disorder.
- Side effects
- Unwanted or harmful reactions that occur from taking a medication.
- Steady-state
- A condition where the amount of medication in your body remains consistent because you have been taking it regularly for a sufficient period of time.
- Withdrawal
- Uncomfortable or harmful symptoms that can occur when you suddenly stop taking a medication you have been using regularly.