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nope not at all. I miss doses all the time and have had a great outcome. Like the PP said it's about the cumulative dose. In fact my derm took me off it for 5 days bc I was having bad stomach aches. He said it wasn't a big deal to stop then start again.
Um.. my derm told me the opposite...
I ran out of pills for a week and then started again, she told me not to do that again!