It is a hormone that is very similar to progesterone, and therefore prevents progesterone from working normally during pregnancy. This is the way that is causes a miscarriage.
There have been many different ways to use it for that purpose. When it was initially approved by the FDA, it was used as a dosage of 600 mg of mifeprex, followed by oral misoprostol. Although this worked very well, with a 600 mg dosage the cost of this regimen is very high.
Soon, other ways of using the same medicine were experimented. It was found that lowering the dose to 200 mg (only one third that of the original FDA approved regime), the costs of the pill were brought down without compromising the effectiveness. It worked just as well in causing a miscarriage, but at a fraction of the cost.
Changing the route of the misoprostol was also undertaken. It went from oral (swallowing the pills), to vaginal (putting them in the vagina), to buccal (placing them between the gum and the cheeks). It was found that the vaginal has the least side effects, but may be a bit more difficult technically. The oral had the highest amount of side effects. The buccal had less side effects, and more effective than the oral.
The evidence points to taking 200 mg of ru-486 along with misoprostol 24 hours later either vaginally or buccally as being the best option. The buccal route is probably the easiest.
Therefore, at our medical clinic we have adopted the protocol of taking 200 mg of mifeprex followed 24 hours later with buccal misoprostol. The safety and effectiveness of this medical pill protocol is well established. This regimen has been in use by us for years, and we find it to be highly effective and safe.
We are a community women’s clinic and abortion center that provides low cost, affordable reproductive health care for the women of Southern California, located in Santa Ana, and Orange County.