Can You Change Slynd Dosing From Evening To Morning?

In our latest question and answer, our pharmacist discusses how to change the time you take your Slynd dose.

Question

I took my first Slynd pill at 11:30 pm on 7/31. I need to move the time to take it to an earlier time. I took the pill due today (8/1) at 7 pm (so about 4 hours early) and was going to move it up in 4-hour increments until I get to 7 am. Will this change its effectiveness? I am not taking late - but taking early.

Asked by AWE On Aug 02, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 02, 2022
Last updated Mar 24, 2024

Key points

  • Slynd is a progestin-only pill that allows for greater dosing flexibility compared to the other progestin-only pills on the market.
  • Slynd has a 24-hour 'missed dose' window compared to a 3-hour window for other progestin-only pills.
  • Changing the time you take your dose of Slynd can result in taking two pills within a 24-hour window. This is safe and will not affect how well the pill works, but could cause mild side effects.

Hello and thanks for reaching out to us! What to do when it comes to timing with birth control pills can be tricky, so I'm more than happy to provide some direction here.

What is Slynd?

Slynd is a progestin-only birth control pill that contains the progestin drospirenone. It is an 'extended-cycle' birth control regimen that contains 24 days of active pills (drospirenone 4mg per pill), followed by four days of inactive pills.

Progestin-only birth control pills are sometimes referred to as 'mini-pills' but Slynd is quite different from the other 'mini-pills' available in that it contains a different progestin (drospirenone vs. norethindrone). Additionally, all other 'mini-pills' are taken continuously, without a hormone-free interval. Slynd has a four-day hormone-free interval at the end of each pack.

Greater Flexibility For Missed Doses

One of the positive attributes of Slynd is that it is far more forgiving than other progestin-only pills in regard to missed doses.

For other progestin-only pills that contain norethindrone (e.g. Errin, Camila, Heather, etc...), you only have a 3-hour window to take your pill during your usual dosing time for it to not be considered a missed dose (e.g. if you took your norethindrone-containing pill more than 3 hours late, that is considered a missed dose, which could put you at a higher chance of pregnancy).

Slynd has a 24-hour window for late doses. Essentially, you can miss a dose and as long as you take that missed dose within 24 hours, you don't need to use backup contraception. This is detailed specifically in the prescribing information for Slynd:

If you miss 1 white pill (active pill):
• Take it as soon as you remember. Take the next pill at your regular time. This means you may take 2 pills in 1 day.
• Then continue taking 1 pill every day until you finish the pack.
• You do not need to use a back-up birth control method if you have sex.

Slynd Prescribing Information

In fact, studies show that Slynd maintains its ability to inhibit ovulation (which is how it prevents pregnancy) even when up to four doses (i.e. pills) in a row are taken up to 24 hours late within one 28-day cycle. One such study concluded the following:

Despite the 4-day hormone-free period and multiple intentional 24-h delays in tablet intake, ovulation inhibition was maintained. This property distinguishes this new-generation oestrogen-free pill [i.e. Slynd] from traditional POPs by allowing the same "safety window" or flexibility in intake as combined oral contraceptives without compromising contraceptive reliability.
Contraception . 2016 Apr;93(4):303-309.

Changing The Time Of Day You Take Your Dose

I say everything I have written above just to emphasize that Slynd offers some flexibility in dosing while being able to maintain its effectiveness in preventing pregnancy.

You mention in your question that you want to change the time you take your daily dose from 11:30 in the evening to 7 in the morning. How you describe you are doing this is perfectly safe (taking your next dose 4 hours early every day until you get to your target time). This won't affect how well the pill works and you are not outside a 24-hour window between any doses.

I will say that it would also have been fine, and perhaps a little less cumbersome, to just switch to a morning dose after your last evening dose (i.e. take your 11:30p dose, then take your next pill at your new morning time).

This would mean you are, again, taking two pills within a 24-hour window, which is perfectly safe. There is a slight increase in the risk of feeling a little nauseous and spotting, since you are taking more hormones than you usually do in a 24-hour time window, but these effects should be relatively mild and resolve quickly.

This method of changing your dose from the evening to the morning will get you to your new dosing time quicker. With birth control pills, consistency is key in regard to getting your body used to the medication. The more consistent you can be with the timing of your dosing, the faster you'll experience fewer side effects, like spotting and breakthrough bleeding.

As a quick side note here, if you ever want to change your dose from the morning to the evening, you, can simply take your first dose at your usual morning time and your next dose at the new evening time. This will again result in two pills within 24 hours, which may cause some of those side effects mentioned, but is better than going more than 24 hours between doses (which would signify a 'missed' dose).

Final Words

Thanks so much for your question and please reach out to us again if anything else comes up!

References

  • Slynd Prescribing Information, Slynd Manufacturer Website
  • Maintenance of ovulation inhibition with a new progestogen-only pill containing drospirenone after scheduled 24-h delays in pill intake, PubMed
  • Drospirenone Monograph, PubMed
  • Clinical relevance in present day hormonal contraception, PubMed
  • Oral Contraceptive Pills, NIH

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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