What if my child misses a dose?

It happens.

Your child forgets their medication. A dose gets left at home. They refuse it. They fall asleep before taking it. Or they vomit shortly after taking it and you’re not sure whether the medication stayed down.

When your child has Crohn’s disease or ulcerative colitis, it can be stressful wondering what to do next.

The most important thing to know is:

There isn’t one missed-dose rule for every IBD medication.

What you should do depends on the medication, dose, timing and your child’s individual treatment plan. Instructions can also vary between countries and medicines.

If you’re unsure, check the medication information provided with your child’s medicine or contact their IBD team or pharmacist for advice.

💊 Don’t automatically give a double dose

One of the most common questions parents have is:

“Should I give two doses to make up for the missed one?”

Don’t assume the answer is yes.

Some medicines have specific instructions about when a missed dose can be taken, while others may need to be skipped until the next scheduled dose.

Never give an extra dose unless your child’s healthcare professional or the medication instructions specifically tell you to.

If you’re unsure, ask before giving another dose.

⏰ What should I do if we realise soon after the scheduled time?

The correct action depends on the medication.

For some medicines, taking the dose when you remember may be appropriate if it is not too close to the next dose.

For others, the missed dose may need to be skipped.

That’s why it’s important to check the instructions for your child’s specific medication rather than following advice you’ve seen for another medicine.

If you cannot find the instructions, contact your pharmacist or IBD team.

📅 What if we miss a dose by a whole day?

If your child has missed a scheduled dose and the next dose is approaching, don’t guess what to do.

Write down:

• The medication name

• The dose

• When the dose was supposed to be taken

• When you realised it was missed

• When the next dose is due

Then contact your child’s pharmacist or IBD team for advice. This is particularly important for medicines that are taken on specific schedules or treatments where timing affects how the medication works.

💉 What if my child misses a biologic injection?

Biologic medications can have different dosing schedules, including injections given every few weeks or other intervals.

If your child misses a biologic injection:

Don’t automatically give the injection as soon as you remember or change the schedule yourself.

Contact the healthcare team managing your child’s treatment.

They can tell you when the missed dose should be given and whether the next scheduled dose needs to change. If your child receives biologic treatment through an infusion centre or hospital, contact the service that arranged the treatment.

💧 What if my child vomits after taking their medication?

This can be particularly confusing.

Whether your child needs another dose depends on:

• The medication

• How soon after taking it they vomited

• Whether the medication was likely absorbed

• Whether you can see the medicine in the vomit

• Your child’s individual treatment plan

Don’t automatically repeat the dose.

Contact your pharmacist or IBD team and tell them:

“My child took their medication at 8 am and vomited at 8:30 am. Should we repeat the dose?”

Having the exact timing can help them give you the right advice.

🤢 What if my child has diarrhoea?

Diarrhoea can sometimes affect how medicines are absorbed, depending on the medication and what is happening in the gut.

However, there isn’t a general rule that a child should automatically repeat medication because they have diarrhoea.

If your child is having a significant IBD flare, frequent diarrhoea or vomiting, contact their healthcare team for advice about their medications and hydration.

😴 What if my child falls asleep before taking their medication?

This is a common problem, especially with medicines taken at night.

Whether you should give the medication when they wake up or wait until the next scheduled dose depends on the medicine.

Check the medication instructions or ask your pharmacist or IBD team. Try not to turn one missed dose into a stressful event for your child. The important thing is to work out what to do next and get back into the normal medication routine.

🧒 What if my child refuses their medication?

Sometimes a “missed dose” isn’t really about forgetting.

Your child may refuse because:

• They don’t like the taste

• They struggle to swallow tablets

• They’re worried about side effects

• They’re tired of taking medication

• They are embarrassed

• They don’t feel sick anymore

• They are angry about having IBD

• They want more control over their treatment

If refusing medication is becoming a pattern, tell your child’s IBD team.

There may be ways to make treatment easier, such as a different formulation, medication routine or additional support.

Don’t let medication become a daily battle if you can avoid it.

Try to understand what’s making it difficult.

🧠 What if my teenager is forgetting doses?

As children get older, medication responsibility gradually shifts from parent to child.

This is an important part of becoming independent with IBD treatment, but it can take time.

Instead of simply reminding them repeatedly, try helping them create a system that works for them.

They could use:

• Phone reminders

• A medication calendar

• A pill organiser, where appropriate

• A medication tracking app

• A routine linked to another daily activity

• A written checklist

The goal is to help them learn how to manage their medication independently — not to expect them to get everything right immediately.

📝 Keep a record of missed doses

If your child misses a dose, make a quick note.

You could record:

Medication

Dose

Date

Scheduled time

What happened

Advice received

This can be particularly useful if missed doses happen more than once.

If your child has several missed doses, let their IBD team know. They may want to understand why it is happening and help find a more manageable treatment routine.

What if my child misses several doses?

If your child has missed multiple doses, contact their IBD team or pharmacist rather than trying to catch up yourself.

This is especially important if:

• Your child is taking medication for an active flare

• Their symptoms are returning

• They have missed several doses of a regular treatment

• They are taking an immunomodulator or biologic

• They have stopped taking medication altogether

• You aren’t sure when their next dose should be

Your healthcare team can tell you exactly what to do.

🔥 Could missing medication cause an IBD flare?

Consistently missing prescribed IBD medication can make it harder to keep the disease under control for some children.

However, one missed dose does not automatically mean your child will have a flare.

If your child’s symptoms begin changing after missed medication, keep an eye on what is happening and contact their IBD team if symptoms persist or worsen.

Don’t assume every new symptom is caused by the missed dose. Your child could also have an infection or another reason for feeling unwell.

🌍 Does the advice vary between countries?

Yes.

Medication names, formulations, approved uses and prescribing instructions can vary between countries.

Even if another parent tells you what they were instructed to do with the same-sounding medication, their situation may not be identical to your child’s.

For international IBD families, the safest approach is to follow:

1. Your child’s medication instructions

2. Your child’s IBD team’s advice

3. Advice from a pharmacist familiar with the medication

If you have moved countries or changed healthcare providers, make sure your new team has an up-to-date list of your child’s medications.

📞 When should I call the IBD team?

Contact your child’s IBD team if:

• You’re unsure what to do after a missed dose

• Several doses have been missed

• Your child has stopped taking their medication

• Your child vomited after taking medication

• You are concerned about a medication side effect

• Your child’s symptoms are returning

• Your child is having a flare

• You aren’t sure when the next dose should be given

• You are changing healthcare providers or travelling internationally

You don’t need to wait until your child becomes unwell before asking for advice.

🚨 When is it an emergency?

A missed dose on its own is usually not an emergency.

However, your child may need urgent medical attention if they are seriously unwell, regardless of whether a medication dose was missed.

Seek urgent medical care if your child has symptoms such as:

• Severe or rapidly worsening abdominal pain

• Heavy or ongoing bleeding

• Severe dehydration

• Repeated vomiting and inability to keep fluids down

• Fainting or severe weakness

• A very swollen or unusually tender abdomen

• Difficulty staying awake or a significant change in alertness

• A high or persistent fever with your child appearing very unwell

If you believe your child is experiencing an emergency, seek urgent medical care rather than waiting for the IBD team to respond.

❤️ Don’t panic over one missed dose

If you’ve just realised your child missed their IBD medication, take a breath.

Don’t automatically give an extra dose. Don’t double the next dose.

Check the medication instructions and contact your child’s pharmacist or IBD team if you’re unsure.

One missed dose doesn’t mean you’ve failed or that your child’s treatment has been ruined.

What matters is knowing what to do next and getting back to a safe, consistent medication routine.

And if missed doses are becoming a regular problem, tell your child’s healthcare team. They can help you find a solution that works for your child and your family.

When it comes to IBD medications, it’s always better to ask than to guess.