What to Do When Your Pill Looks Different

You open your prescription bottle and do a double-take. The pills you’ve been taking for months were always tan and round, but now they’re blue and oblong. Did the pharmacy make a mistake? Is it safe to take?

Changes in the color, shape, or size of a prescription medication can be confusing—even alarming. But according to health experts, what you do next is critically important. Some people, worried that they’ve received the wrong medication, simply stop taking the pills. That reaction, while understandable, can be dangerous.

A study from Johns Hopkins University found that changes in the appearance of pills may cause serious lapses in treatment. Researchers looked at heart attack patients who were prescribed generic medications. Among those whose pills changed shape—even when the dosage stayed the same—66% stopped taking their medication. When the pill color changed, 34% stopped. For patients recovering from a heart attack, missing doses of heart medication can raise the risk of another serious event.

So why do pills change appearance at all?

The answer lies in the pharmacy supply chain. When you get a prescription filled, your pharmacist may source the drug from various manufacturers. These companies make the same medication but in different formulations. One version may be round and pink; another may be white and capsule-shaped. These variations are allowed under FDA guidelines as long as the active ingredients, dosage, and safety standards remain consistent.

Still, it’s completely reasonable to feel concerned if your medication suddenly looks unfamiliar.

Here’s what you should do:

1. Don’t stop taking the medication until you verify the change. Instead, take a moment to check with your pharmacy. Pharmacists can confirm whether the pills you received are correct and explain why they may look different from your last bottle.
2. Use a pill identifier tool. Trusted websites can help you verify the pill based on its color, shape, imprint, or markings. Search “identify pill” in a browser and use a reliable medical site, such as Drugs.com or the National Institutes of Health’s Pillbox tool, to double-check.
3. Ask questions. If you still feel unsure, talk to your doctor or pharmacist. Most pharmacists are happy to walk you through any changes and explain how different manufacturers may package the same medication differently.

Being aware and asking questions is always better than skipping doses. Whether the pill is heart medication, a daily thyroid tablet, or an antidepressant, consistency matters. Missing even a few days of medicine can interfere with treatment and, in some cases, cause serious health issues.

Generic medications are a safe and affordable option for many patients, and their appearance can vary based on the manufacturer. But patients shouldn’t be left in the dark.