10 days past a due dose is 1.43 half-lives at the seven-day half-life this class runs on, which leaves about 37.1 per cent of that dose still circulating. One line of arithmetic: remaining fraction is one half raised to days over half-life, so 0.5^(10÷7) = 0.3715. At 37.1 per cent you have not been off it in any meaningful sense. The interval stretched from 7 days to 17 and the trough went lower than usual; that is the whole of what happened. What the product label says and what the pharmacokinetics say are two different answers here, and the first is the one that governs. Restarting, holding or stepping down after a gap is decided under supervision, and nothing here is medical advice.
Answer first: it depends on the half-life and on how long ago the dose was due, and for a weekly agent the tolerance is much wider than people fear.
With a one-week half-life dosed weekly, missing one dose means exposure falls by about half over the following week — the same trough you would reach if you simply extended the interval. That is well within the range the agent operates in.
Weekly dosing accumulation, 7-day half-life
| Week | Fraction of steady state | Trough as × dose |
|---|
| 1 | 50 % | 0.50 |
| 2 | 75 % | 0.75 |
| 3 | 88 % | 0.88 |
| 4 | 94 % | 0.94 |
| 5 | 97 % | 0.97 |
| 6 | 98 % | 0.98 |
This is why a four-week step interval is approximately, but not exactly, steady state.
More usefully, the published guidance for the weekly agents is broadly: if the missed dose is remembered within about five days, take it and continue on the usual day; if more than five days have passed, skip it and take the next scheduled dose.
Within about five days for a weekly agent, take it. Beyond that, skip and resume.