Since the year 2000, the abortion pill has been FDA approved for medical means of termination. At that time, not as much research had been done to know the best dosage and combination of medicines to make it work best. So the best known evidence at that time dictated a dosage of 600 milligrams of mifepristone (RU-486), followed 48 hours late by 400 micrograms of misoprostol (cytotec). This was well tolerated and very effective: it worked approximately 92% of the time. This was the most widely used method for the early part of the decade. The major drawback with this is that the medication cost is very expensive, which makes it unaffordable by many women that need it.
Misoprostol is a prostaglandin that has been available in the US for a very long time, and is relatively more affordable. Prior to FDA approval of RU-486, this was the main way to carry out an abortion by medical means. It involves 600 to 800 micrograms of misoprostol inserted vaginally every 8 to 12 hours for a few doses until the pregnancy expells. Although this is a relatively cheaper choice, the downside is that it is not as effective. It works about 70-80% of the time, which compared to the mifepristone is somewhat less effective. Since the other choices are available, this is the least attractive way to have a medical abortion and is not recommended.
Methotrexate is a a compound that interferes with cell synthesis and is toxic to growing cells. It is commonly used as a chemotherapy agent for the treatment of cancer. It is also used to treat an abnormal tubal (ectopic) pregnancy. Methotrexate is given as an injection at a dosage of 50 milligrams/square meters, followed 48 hours later by misoprostol. This is well tolerated, and quite effective: about 90%. The drawback is that even though it is available in the US, obtaining it can be difficult by healthcare providers since it is an injectable chemotherapeutic agent. Also, even though it is usually well tolerated, its possible side effects can be more dramatic than the other options. Most doctors do not use it.
After the initial FDA approval of mifeprex, further studies have been done, looking at different combinations and dosages of the same medicines. It has been found that a dose of only 200 milligrams of mifeprex, followed 24 to 36 hours later by 800 micrograms of misoprostol is actually slightly more effective than the initial FDA approved protocol. It works in about 95% of the time. Also, because it uses a lower dosage of RU-486 it becomes more affordable and therefore more readily usable by more people. For this reason, this is the recommended protocol by the American College of Obstetrics and Gynecology for medical abortion. It is the most effective, most affordable form of the abortion pill, and with the least risks and side effects of all the choices.
At our abortion clinic, we use this method because of the above reasons.
If you are in need of the abortion pill, or have questions about it, call our office at 714-966-9094.
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.